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F <br /> Diistance to Public Sewers 7 S9r Connection necessary: Yes No,- <br /> Does existing septic system comply with Ord. #549 : Yes No— <br /> Unknown If no, explain: <br /> r <br /> Describe septic installation to 'be installed: CEJ 0bc, she,+. <br /> 2 . WATER SUPPLY <br /> Is water supplied. by private well: Yes No Is well proper: <br /> Yes No State deficiency:' <br /> Does existing or porposed use make this weil public water: Yes <br /> No= Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSF <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. ELY QR_VECTOR PO'CENTIAL <br /> State possible vector potential & necessary control: <br /> 5. MQUE.T/BATH CACIUIRS <br /> No. & locution existing: Additional <br /> facilities needed <br /> 6. PREYTQna OPRRATION HISIORX <br /> 7 . GENERAL SANTIATTON <br /> State any problems not previously noted: <br /> 8 . Pi7,_EULATT014 DENSITY <br /> Appx. No. People per sq. mi . <br />