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1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord. 0549 : Yes No_,._. <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is crater supplied by private well : Yes a 'No Is well proper: <br /> Yee No State deficiency: <br /> Does existing or porposed use crake thio well public water: Yes <br /> No Sample of well water taken: Yes— No Date taken <br /> Results Additional information or comments <br /> 3 . QARBAGE & REFUSE <br /> Licenced scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLY. M SQUTTQ ORyZ,TnRB2)frNTIAI, <br /> State possible vector potential P.c necessary control: <br /> 5 . TQT , .T/BAT14 FAQUITE3, <br /> No . & locution existing: Additional <br /> facilities needed - - - <br /> 6. PREVIOnS OPERA ON HTS ORY <br /> 7 . GENERAL SAJITTA`l' —OA <br /> State any problems not previously noted: <br /> 3 . POP I ATTON DFS TTY <br /> Appx. No . People per sq. mi. <br />