Laserfiche WebLink
1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord . 41549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY e) <br /> Is water supplied by private well : Yes tJo Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use rnake 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 & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. =� MosouiTy OR vE^.TO m)rimT T <br /> State possible vector potentiftl necessary control: <br /> 5 . TO , .T/PATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed _ <br /> 6 . PREV_TO(15 OPERATION HISTORY- <br /> 7 . <br /> ISTO r7 . QENERAL SAPJITATION <br /> State any problems not previously noted : — <br /> 8 . pOPULATIOPd LSE i `1,:)7TY <br /> Appx. No . People per sq . mi . <br /> _* y t) q;2- <br /> L' <br />