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1 . SEWAGE �; D <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 wkt,46r supplied by private well : Yes No Is well proper: <br /> Yes T No State deficiency : <br /> Doeexisting or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Resu is 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 . FLYL MOSQUITO OR V EC TCa- o,r <br /> Stare possible vector potentin & necessary control : <br /> 5 . TQILET/BATH FACILI3.'E <br /> No . & location existing: __ _ Additional <br /> facilities needed-- '// <br /> 6 . PREVIOUS OPERATION H. �M <br /> 7 . GENERAL SANIZAI ON <br /> State any proi)lems not, previously noted: <br /> 8 . POPULATIQU 2EA _Y_ <br /> Apex . No . People per sq. mi . <br />