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_ a <br /> SRWAGR <br /> Distance to Public Sewers Connection necessary: Yes No�., <br /> Does existing septic system comply with Ord. #549 : Yes No� <br /> Unknown If no, explain: <br /> S eacribe septic installation to 'be installed: 11 <br /> u <br /> 5 <br /> 2. WATER__OULY <br /> Is water supplied. by private well : Yes No Is well proper: <br /> Yes No State deficiency: <br /> �f <br /> t <br /> Does existing or porposed use make this well pblicw atU r:Yes <br /> Sample of well water taken: Yes No I; Date taken <br /> Results Additional information or comments <br /> i� <br /> 3 . GARBAGE & REEIJSE <br /> Licensed scavenger pick-up: Yee No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: ,a <br /> 4. FLY• M0Ej UITG OR VZQTQR EQ'PENTIAL 1 <br /> State possible vector potential ex necessary control: <br /> 1 <br /> 5. TOTLETZB6TH FACTLITES <br /> No . & location existing: Additional <br /> facilities needed h _ <br /> 6. L'REV24�f�S C:PERAI'Tf7�� HT�Tt7RY <br /> Ir <br /> 7 . GENERAL SAUTTATION <br /> State any problems not previously noted: � <br /> Appx. No. People per .sq. mi. � <br />