Laserfiche WebLink
sr G- . <br /> SEWAGE /1( <br /> Distance to Public Sewers onnec1t3d7n�=esary: Yes No <br /> Does existing septic system comply with Ord . sr5-�9 : Yes No_ <br /> Unknown If no, explain : Y <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY "- w ��✓� �� / <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porpcsed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additicnal information or comments <br /> 3 . GARBAGE & R .FUSF <br /> Licenced scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem : <br /> 4 . ELY. MOSQUITO OR V -^,TQj�_ZCi'f N TAIL <br /> State possible vector potentiftl & necessary control : <br /> 5 . TOILET/BATH FACILITES <br /> No . & location existing : _ Additional <br /> facilities needed- <br /> 6 . <br /> eeded6 . PREVIOUSOPERATION HIST _ RY <br /> -#a -1 f W►je.9tr <br /> :� <br /> 7 . MERA 1AMTAMON <br /> State any pro'blemy not previously noted: <br /> 3 . POPULATION DENSTI.V <br /> Appx. No . People per rc_1. mi . _ <br />