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SEWAGE <br /> Distance to Public Sewers _ Connection necessary: Yes No.w,. <br /> Does existing -Aseptic system comply with Ord. #x549 : Yes No <br /> Unknown- If -no-d explain: <br /> Describe septic installation to 'be installed: <br /> i <br /> 2. WA ET_R gUPj!Jsj <br /> Is water supplied. by private well : Yes No Is well proper. <br /> Yes No State deficiency <br /> i <br /> Does existina 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 . UABBASE & REEME <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY. MOSQUjTfl__DRVE-C.1012 FQ'r ' <br /> State possible vector potential. & neceasary control: <br /> 5 . MILEUBATHIACTLITRa <br /> No. & location existing: Additional i <br /> facilities needed <br /> 6. BaRyTOU rERATTQH HTSTOR <br /> 7. aENERAI, 56HTIATT-0 <br /> State any problems not previously noted- <br /> 8 . <br /> oted:8 . [} a T v <br /> Appx. No. People per sq. mi. <br />