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Distance to Public Sewers _ Connection necessary : Yes No_ <br /> Does existing septic system comply with Ord . #549 : Yes-_ No_ <br /> Unknown If no, explain: <br /> Describe <br /> septic installation tp be installed: <br /> _7/�// Y�/.G f!$' (/A,"'<-•v�'_�+'� .!''.,,;,... I_ J�`�""�'.d`'yw .. - .. '`s."�s�„�+"'' i."`4�* ' ;;�':®'rg".!'°+w,r."q'r`' <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes 2!f No Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use make this well public water : Yes <br /> No 1_X Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REEUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential Problem: <br /> 4 . FLY , Mt�SOUIT(_) Ji_Y_Z )t=),II,�ITI <br /> State possible vector poteritiFi.l & nec:;essary control <br /> 5 . TQLI ET/BATH FACI='M <br /> No . & location existing: — Additional <br /> facilities needed — <br /> 6 . PREVIOUS OPERATION =n S= <br /> 7 . GENERAL SANI' K�U. <br /> State any problems not previously .noted : <br /> 8 . P�-IPULATIQN DEN== <br /> Appx. No . People per sq. ml . -;A <br />