Laserfiche WebLink
1 . SHAG R <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 /> IJAW <br /> p O <br /> 2 . MATER SUPPLY <br /> Is water supplied by private well : Yes Flo Is well proper: <br /> Yes No State defici-ncy : <br /> Does existing or porposed use rmake this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional, information or comments <br /> V4* <br /> V"/-&� \vzk7F3 at Ao-<'d� <br /> Licenced scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem:-- <br /> 4. <br /> roblem:_...._4. FLY . MOSQUITO _ R YE TOR P TEUTTAL <br /> State possible vector potentiitl ?A necessary control: <br /> 5 . TOILET/BATH FAc'ILTTM <br /> No . & location existing : ___ Additional <br /> facilities needed- <br /> 6 . PRFVIOnS GPFRA"L TO.' HISTORY <br /> 7 . GENERAL_ SANTIATTON <br /> State any problems not Previously noted- <br /> 3 . <br /> oted:S . 1!nPT1LA'1 T2j )F"YJ <br /> Appx. No . People per sq. m i . <br />