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.. SEWAGE <br /> Distance to- Public Sewers *— Connection necessary: Yes No-< <br /> Does existing septic system comply with Ord. #549 : Yes-,ZNo— <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. NATER SUPPLY <br /> Is Water supplied- by private well: Yes Nod Is well proper: <br /> Yes No State deficiency: . e"' <br /> Does existing or porposed use make this well public Water: Yes <br /> No_� •+Sample of well water taken: Yes NomDate taken <br /> Results Additional information or comments <br /> 3 . aABBAGE & REFUSE <br /> Licensed scavenger pick-up: Yea-Y, No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. ELY, MQkU1T.Q 08 ROTOR PQTENTTALi4 <br /> State possible vector potential FA necessary control: <br /> I <br /> 5. ri.ACTLIXES <br /> No. & location existing: 926Additional <br /> facilities needed <br /> 6. PREVInRS OPERATIOU HISIORY <br /> cw6 C' CIA <br /> 7 . <br /> State any problems not previously noted: ,0,0e _" 0 <br /> .1 <br /> s . MR111,61IM 12ENaTTV - <br /> Appx. No. People per .sq. mi. 9& <br />