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rLtJ 1 MAN <br /> (Draw To Scale) <br /> SCALE " TO ' <br /> 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 all existing and proposed structures,including covered areas such as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal systerrf 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 r'adiUs 'of'75 feet on the property or adjoining prooert.y. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> I <br /> LJ <br /> I I J <br /> - I <br /> , <br /> I I7 <br /> ".b'P• i.' • i. t r. yl.. z I^.J .,l,` RSt.?• fyjz• v_! <br /> I <br /> I <br /> I <br /> t � <br /> I <br /> I { <br /> t <br /> ' Y <br />