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Distance to Public Sew /�/ A Connection neceesar-y: Yes No `— <br /> Does exiating" septic system comply With Ord. #549 : Yes-� No— <br /> Does <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> N� <br /> 2. WATER SUPPnY <br /> Is Nater s plied. by prilratz ael Yes `/No Is Well proper: <br /> Yea bio / State deficiency:_ at las aNe (,"u-co-t-Aded <br /> Does e- sting or porposed use make thia ' l public, crater: Yater: <br /> F No Sample of well Water taken- Yes No Date taken�N <br /> .9esu—It a ' Additional information or comments <br /> 3 . GARBAGE & RRFDSK <br /> Licensed scavenger pick-up: Yes NO.-._ S ice Area No.� <br /> Other proposed disp al method: <br /> Potential problem. <br /> 4. FLY, M0,AQUTTn QR VRI,IT0R\,PnT7MTTAL <br /> State possible vector po ntilt' n essary control: <br /> 5 . TnILFT/BATH TACILITFG <br /> No. & location existing: 9dditional <br /> facilities needed <br /> I <br /> 7. GFNFaar, `A`17-ATTny <br /> State any Pro oiems o t pre•rlous].? noted: <br /> 9 . POTtMAmT ,,J7�--'V-377jr <br /> Anna. Per gc, E.l <br />