Laserfiche WebLink
1 . 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 water supplied by private well : Yes iso Is viell proper: <br /> Yes No State deficiency: <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water tarsen: Yea No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential Problem- <br /> 4 . <br /> roblem:4 . ELI, MOSGrU.LTCi OR V ^TOaPS.)'f ,.NTT r, <br /> State possible vector potentiftl & necessary control : <br /> 5 . TQILET/BATH FACILITES <br /> No . & locution existing : Additional <br /> facilities needed- <br /> 6 . <br /> eepied6 . PR VTOPE OPERATION HI STORY <br /> r <br /> 7 . GENERAL SANIT,8TION <br /> State any problems riot previously noted: <br /> rlJl 1 <br /> 8 . POPUL ION T-)F,LIS T 11 <br /> APpx. No . People per rq. mi. <br /> &J204� C1 <br /> 7' S <br /> L d r xs-p <br /> OL T /� ->S /� ¢, <br />