Laserfiche WebLink
f <br /> .. SEWAGE ' <br /> f' Distance to Public Sewers Connection necessary: Yes No— <br /> Does ekisting septic system comply with Ord. #549 : Yes No_,,,, <br /> Unknown If no, explain: <br /> i <br /> Describe septic installation to 'be installed: <br /> 2. VATER E EMPLY <br /> Is water supplied. by private well : Yes No Is well proper: <br /> r Yes No State deficiency: <br /> I . <br /> Does existing or porposed use make this well public water: Yes <br /> No— Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . ELY, MQSOUTTQ QE YYMQTQR PQlcr, ITAL <br /> State possible vector potentirtl necessary control: <br /> 5 . jQTLET/BATH FAQILITF.S <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. PREM QRS r.PRRATTOM HISTORY <br /> 7 . GENERAL SANTIATION, <br /> State any problems not previously noted: <br /> 3 . PQPULATTt�tX flF�i;T'T� <br /> APpx. No. People per sq. mi. <br />