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r <br /> a <br /> 1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes X No_ <br /> Does existing septic system comply with Ord . #549 : Yes _ITO <br /> Unknown - If no, explain: <br /> Describe septic installation to be installed: <br /> 4-��24 <br /> Z . MATER SUPPLY <br /> Is water supplied by private well : Yes No FIs well proper: <br /> Yes No State deficiency : <br /> �_j 0 a-t 6,1 c, 1. ' = L. <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 /> l.J ) L,1,✓-t __�b r u,-I -- <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLYS MOSQUITO ORS yZ=,,' QZC)Z2NTIAL <br /> State possible vector potentiF-tl necessary control : <br /> 5 . ET/BATH FACIA <br /> No . & location exi._.ting: —_. Additional <br /> facilities needed _ <br /> 6 . PREVIOUS OPERATION HI Lffl 1 <br /> t <br /> 7 . GENERAL SANITA1 UM. <br /> State any problemo, not previously r��tEd : — — <br /> S . POPULATIQN.Ij SIT_Y <br /> Appx. No . People per sq . mi .- <br /> _ <br />