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} <br /> L <br /> aSEWAU <br /> Distance to Public Sewers ' Connection necessary: Yes No <br /> Does existS septic system comply with Ord. #549 - Yes No_ <br /> Unknown � If no, explain: <br /> 20 <br /> Describe septic installation to 'be installed: <br /> 2 . WATER.5L7EETjj / <br /> Is Water supplied. b;r private well: Yes No Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porposed use make this well puhl�c Water: Yes '� <br /> No Sample of well water taken: Yes No Date taken <br /> Results ``Additional information or comments <br /> 3 . GARBAGE & REFaBT <br /> Licensed seavenaer pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Pote tial problem: <br /> 4. ^ n , MTTAL <br /> State possibl vector potential nec Bary control= <br /> 5 . n + r <br /> No. Fc location e.cisti g: <br /> Additional <br /> facilities needed <br /> 8. EREVIOGEj Q "TO <br /> 7. <br /> State any 7/1"llems not previously noted: <br /> 3 . POPUTASr v <br /> t Appx. ' People per .sq. mi. <br />