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SEWACaR <br /> Distance to Public Sewers Connection necessary: Yes No-4Z <br /> Does existing septic system comply with Ord. #549 : Yes--L-L- <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WATER S ]pEI.t <br /> Is water suppliedby private well : Yes '� No Ie well proper: <br /> Yes No State deficiency: <br /> Does a isting or porposed use make this well public water: Yes <br /> NoSample of well water taken: Yes Nom Date taken <br /> Results - Additional information or comments <br /> 3 . GARBAGE & REFUSR <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR ECTOR POTENTIAL <br /> State possible vector potentiftl ex necessary control: <br /> 5 . TQTLET/BATH FACILITES <br /> No. ei location existing: Additional <br /> facilities needed <br /> 6. PREVInnS OPREATTOM HTSTORY <br /> 7. GENERAL. SANITATTQN <br /> State any problems not previously noted:_1�? <br /> 3 . EQQPUT,ATTQN DENSTTY <br /> Appx. No. People per sq. mi. <br />