Laserfiche WebLink
1. SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic system comply with Ord. <br /> If no, explain: Nr569: Yes No _ Unknown <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well; yes <br /> No _ Is well proper: Yes No <br /> deficiency: <br /> State —'- <br /> {y,c �, •� „<<� I _ <br /> Does existing or proposed use make this well public water: Yes _ No - <br /> Sample of well water taken: Yes _ No ✓Date Taken <br /> .— Results <br /> 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. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State po ible vector potential & necessary control: <br /> 5. AIR POLLUTION PO7EJ= <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILE BATH FACILITIES <br /> No. & location existing: (V a L Additional facilities needed <br /> 7. PREVIOUS OPERATION H STORY , <br /> A INi <br /> o. GENERAL SANITATION <br /> State any problems not previously noted: <br /> o K <br /> 9• POPULATION DENSITY <br /> Appx. No. People per sq, mi. <br />