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Distance to Public Sewers q Connection necessary- Yes No f <br /> Does existing septic system ' compl y with Ord. #x549 : Yes No,.r,. <br /> C7nknown If no, explain: <br /> Describe septic installation to *be installed: <br /> 2 . HATER SUPPLY - <br /> Is water s plied. b9 private Biel Yes `/iso Is well proper: <br /> Yes NoVState deficiencY:_ ` �� wells aNe _G ss ►+�- <br /> Does e 4tin8 or pornosed use make thin 1 public.• water:' Y <br /> No Sample of well water- t6ken: Yes No Date taken N <br /> Result$ - Additional information or comments <br /> A <br /> 3 . GARBAGE & RFFUSR .- .� <br /> Licensed scavenger pick-up: Yes No., ice Area No. <br /> Other proposed lisp al method: <br /> Potential problem: <br /> '".ro"n,mmTTAr, <br /> State possible vector pa ntial & n essary control: ' ' <br /> Tn_ 7LFT/BATft rACTT,ITFG <br /> No. & location existing: Additional. <br /> Facilities needed <br /> s . ^�nn^ rp n n <br /> ;T <br /> t <br />, <br /> I <br /> 7. GFNFw_.a_L .SA%TT A <br /> State ,:n;, rroo;ems ot prer; ou:l7 noted : <br /> t <br /> TTY <br /> Appx . go . Per sc u! <br /> i <br />