Laserfiche WebLink
1. ScWAOE (2) <br /> Distance to "ublic Severs Connection necessary: Yea _ Nc <br /> Does ex- , iry� saptlo . WIM oo T-with Ord. 649: Yes No Unknown <br /> If ino, eiplai0:" — — <br /> Describe septic installation to be installed: <br /> Additional information or cosaaenta: - <br /> 2. WATER <br /> Ip 'vater eupplied.by private well: Yes llo Ie well proper: Yee No <br /> 3,4" deficiency: _ — �- — <br /> Does existing or proposed use make this well public water: Yee _ No <br /> Sample of well water taken: Yes — No Date Taken Results~ <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-upe-"Yes _ 6o 'Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4• FLT, HJSQUIIU OR VECTOR POTENTIAL - - _ <br /> State possible vector potential k necessary control: <br /> $ . AIk 1'OLL1JTIt,.. iOTcNT'lAL i <br /> Mate possto:e burninL• . <br /> or proccsstnb lwltutants 6 necessary control: - <br /> 6. TUI[ET/M-ni FACILITIES <br /> ho- location existing: Additional racilities needed <br /> 7. rtwluU:; ut .. :'TION <br /> b- GEI+ENAL :;Akj iATION <br /> :;Latu atty problems nut 1.1 rviously nu:. .1 : <br /> POPULATION DENSITY <br /> Appx . ;4o. People per sq, mi . <br />