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1. Names of streets or roads nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. <br /> 3. Dimensioned outlines and locations of ail existing and proposed structures,including covered areassuch as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <br /> 5. Location of other wells within radius of 75 feet on the property or adjoining property. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> --- -----T ------------------ <br /> ti <br /> - ----- -- - - - - - - - ----- <br /> - ----- -- - - - - - - - ----- <br /> -- ----- -- - -- ----------------- --- <br /> -- ------- - -- - <br /> ---------- -:T-::H --- - ----- - <br /> V <br /> 0 <br />