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�. SEHAGE <br /> Distance to .Public Sewers _, Connection necessary: Yes Nom <br /> Does existing septic system comply with Ord. 0549 : Yes No— <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WATF R SC)PPI,Y <br /> Is water supplied. by private well: Yes No-_�gIs well proper: <br /> Yes No State defici.encY: <br /> Does xisting or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Res lts Additional information or comments <br /> 3 . GARBAGE & RRFUSE <br /> Lic . sed scavenger pick-up: Yee No Service Area No. <br /> Other roposed disposal method: <br /> Potent 1 problem: <br /> 4. TOR PS�T.2,IfT.IAL, <br /> State possi a vector potentiF�l �.z necessary c rol: <br /> 5 , r <br /> No . ek location existin Additional <br /> facilities needed <br /> 6 . PREYTQUZ OPERATION n <br /> 7 . GENERAL EA111 T 1 O <br /> State any V-'ro'bl.emz not previously notad:_._. <br /> S . (i 1 �" v <br /> PP%T. No. People per ..sq. r,i . <br />