Laserfiche WebLink
Y <br /> 1 . SEWAGE <br /> Distance to Public Sewers Connection necessary : Yes No_ <br /> Does existing septic system comply with Ord. #x549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes — No Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porposed use make this well public water: Yes— <br /> No— <br /> esNo— Sample of well water taken: Yes Na Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: - <br /> 4 . ELY, MOSOUITO OR VECTOR Pi'Tr,NTIAL <br /> State possible vector potentiitl & necessary control: <br /> 5 . TOILET/BATH FACILITES <br /> No. ek location existing: Additional <br /> facilities needed <br /> 6 . PRFVInUS GPCRATIoN HTsInRY <br /> 7 . GENERAL. S61ITTAITON <br /> State any problems not previously noted: <br /> 3 . POPULATTQH DENSITY <br /> APpx. No . People per sq . mi . <br />