Laserfiche WebLink
ti <br /> 1 SEWAGE <br /> 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 septic installation to be installed: <br /> Z . WATER SUPPLY <br /> Is water supplied by private well : Yes - "No Is well proper: <br /> Yes No_ Sta te- d�€ icy.: <br /> Leg <br /> Does existing or porpose use make t�sis-Weil puY,7ic wa er: Yes <br /> No Sample of well water taken: Yes No 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 . =,- MOSQUITO QR Y E ) PSIT M AL <br /> State possible vector potential & necessary control : <br /> 5 . TQLI ET/BATH FACILILM <br /> No. & location existing : Additional <br /> facilities needed _ <br /> 6 . RWVTQ119 CPERATION HISTORY <br /> 7 . GENERAL SANI'.�f7 <br /> State any problems not previously noted: - <br /> 8 . <br /> oted: —S . P.QPULATIQN DENSITY <br /> Appx. No. People per sq. mi .- <br />