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(Draw To Scale) <br /> SCALE " TO ' <br /> 1. Names of streets or roads nearest,to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. <br /> 3. Dimensioned outlinesand locations of all existing and proposed structures,including covered areas such as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <br /> 5. Location of other wells within radius of 75 feet on the property or-adjoining property. ` <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. 1F <br /> Al <br /> +41 - <br /> FFIFFIRT_ I I eg�r L <br /> r () <br /> To "17 p v <br /> H <br />