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1 . SEWAGE �� ��� <br /> Distance to Public Sewers fhe�Connection necessary: Yes_ Nom <br /> Does existing septic system comply with Ord. #549 : Yes No_ <br /> Unknown If no, explain: <br /> ✓r�� /ll 6tdF�C f1f�C o�C�f�4/4/:0;" A53- 6 GF <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes No_ Is well proper: <br /> . <br /> Yes. No_ State <br /> deficiency: %'i/FLt <br /> ,I Jlan��'N�G L.�F�H. �O/1/EJJ/C I�LLN �7J�E le���iC ��C �D-F✓�IG/hG�� <br /> yifa `♦+llr/.0/!F P4.lr E od�.�' F .tom ♦W ��o../- a+yNd �' ,C i�tdl E•�f .��c.� <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes_ Nodi Date <br /> Ad t ons 3nformat q ori commends �L 6 aim_ <br /> �r CGS taken— <br /> Results t✓$�9on4� lEgtG/ � f�fidTc Ja�1Fi is �L ✓ u l4`f s � <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No_ Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLY. MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: �i,Pt' <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing : Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION HISTORY <br /> 7 . GENERAL SANITATION. _ <br /> State any problems not previously noted: _-;;�-,E <br /> 3 . POPULATION DENSITY <br /> Appx. No. People per sq. mi. 7.✓Dd✓�i� l <br />