Laserfiche WebLink
1 . SEWAGE <br /> Distance to Public Sewers A)Ilq Connection necessary: Yes_ No_'1 <br /> Does existing septic system ' comply with Ord . $1549 : Yes_ No� <br /> Unknown If no, explain : <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is water SL lied by private well : Yes No_ Is well proper: <br /> Yes_ No State deficiency : <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water tarsen: Yes_ No_ Date taken <br /> Results Additional information or comments <br /> INrale cr � ula � <br /> 3 . GARBAGE & REFUSF, <br /> Licensed scavenger pick-up : Yes_ No_ Service Area No . <br /> Other proposed disposal method: <br /> Potential problem : <br /> 4 . FILL� MOSQUITO OR V z^TO PCrLI� <br /> State possible vector potentir,l R.c necessary control : <br /> 5 . TOILET/BATH FACILITES) <br /> No . & location existing : _ Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION HISTOi <br /> 7 . GENERAL SANITATION <br /> State any problems rot previously rioted: <br /> 8 . PnrULATION DENSTTX <br /> Appx. No . People per sq. mi . <br />