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1 . SEWAGE P' f 7�- c <br /> D' tanceto Public Sewers Connection necessary: Yes No <br /> Doe isting septic system comply with Ord. #549 : Yes No_ <br /> Unknown f no, explain: <br /> Describe septic installation to be installed: <br /> 2 . WATER' SUPPLY - ��F3L► L <br /> Is water u lied b%7 private well : Yes No Is well proper: <br /> Yes No a . e clef icie.ncy <br /> Does existing or purposed 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 /> 3 . GARBAGE & REFCISE - NC, SQr J,�p _ Swk.aII Q►-�w�v I� CG {-!w �4ys, <br /> . Licensed scavenger pick-up: Yes No Service Area No. �J <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . ZILY_,._ MO DUITO OR vECTOR POrliNTIAL <br /> State possible vector potential & necessary control: <br /> 5 . TQILETIBATH FACILI')'ES <br /> No. & location existing : �_ Additional <br /> facilities needed _ <br /> 6 . PREVIOUS OPERATIONH=DffiY <br /> 7 . GENERAL SANT ZA11Q1. <br /> State any problems not previously noted.--- <br /> 8 . <br /> oted:_S . PSS'C1. TLATIQR_IMUTY <br /> Appx. No . People per sq. mi .- <br />