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1. SEWAGE <br /> t� <br /> Distance to Public Sewers / `� Connection necessary: iYes _ No _ <br /> Does existing septic system comply with Ord. #549: Yes. No Unknown <br /> If no, explain: — — <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> f ar �f. _/moil .A � A� Sita 7� <br /> 2. WATER SUPPLY <br /> Is water supplied by pri to we • Yes 1/ No Is well proper: Yes No <br /> State deficiency: -7' G <br /> r I � d <br /> Yes existing or proposed use make this well public water: Ye No _ •)�O <br /> Sample of well water taken: YesNo <br /> — !/� Date Taken Results <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed_ caxenger-pictt=u,p: Yes _ No - - Service Area No. <br /> Other proposed disposal method: <br /> F is roblem: <br /> 1t. FLY, MOSQUITO OR VECTOR POTENTIAL G r <br /> t�? b�r po�entil & ncessary control:,:._ <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible W=111 ng or processing pollutants & necessary control:_ <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY . <br /> 44 6 <br /> 8. GENERAL SANITATIOIJ <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. <br /> ,�1 1,�- �� � �'Z S c�-�.'i z r - �► � �.' '� r � Soya <br />