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�. . SEWAGEi <br /> Distance to Public Sewers X50 4'Connection necessary: Yes '/No <br /> Does existing septic system comply with Ord . #549 : Yes No-7- <br /> Unknown If no, explain: <br /> A� �e xis w, zqSti <br /> Describe septic installatiop ,to be installed: <br /> 14 <br /> 2 . VATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> �45�, die<< �►, C� os�dSD - ,#2- <br /> e-h vu r sc r �✓ve d 6� �u.{,lr c u�ayfe.� � �'-C.. Q�K...c.,� , �,ya/ c.2..-a'" <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 . MQSQUTTQ OR VT^.TOEQ):M.NTJAL <br /> State possible vector potentiitl & necessary control: <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6 . pgEVTOnS OPERATION HISTORY <br /> 7 . QRNEBA , SANTTA"1 TON <br /> State any problems not previously noted: <br /> 3 . POPULATION DEN-,3?T" <br /> Appx. No . People per sq . mi . <br />