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ti <br /> . SEWAGE <br /> Distance to Public Sewers ' Connection necessary: Yes No <br /> Does existing septic system comply with Ord . #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is wa_ tor supplied by proe vte w1 : es 4" No Is well proper: <br /> Yes V No State deficiency : <br /> Does✓existing or porposed use make this well public water: Yes <br /> No Sample of well water tarsen: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . QARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem : -� <br /> 4 . FLY. MOSQUITO QR VEQT0 Ei'rLB=AL <br /> State- possible vector potentiftl necessary control : <br /> 5 . TOILET/BATH FACILITES ! <br /> No. & location existing: Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION H=C1 , <br /> ,✓ r <br /> 17, <br /> 46 as <br /> 7 . GENFRAI SAI IT '1,� 'It) <br /> State any problems not previously noted : - <br /> 8 . <br /> oted : _8 . POP 1 ,ATIt7i_ 4 TENSITY <br /> APpx. No . People per req . mi . <br />