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1. SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes _ No <br /> Does existing septic system comply with Ord. #549: Yes//i '- Unknown r ` <br /> If no, explain: — <br /> 5' cr-e-51 <br /> Describe sep is izWtallation to be installed: - e'- o "Pore e/Z <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes._ No _ Is well proper: Yes No <br /> State deficiency: e <br /> Does existing or proposed use make this well public water: Yes No. '�- <br /> Sample of well water taken: Yes _ No Date Taken Results <br /> Additional information or comments: Z-,-)V./ C �� r-C s 6� j�� dre 11 �L. � <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes _ No Service Area No. 44-1.1 06-1 t1vt <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: )/rAL 0 <br /> r �d lam/a 41- 4z c'Q <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> Al ? /f--r� <br /> 6. GENERAL SANITATION / <br /> State any proble s not previously noted: �� li`i .� c:c- ���1 e- <br /> �a 5 S' &S- <br /> C 142d C' , <br /> 9. IOPULATION DENSITY <br /> Appx. No. People per sq. mi. ,/ i J_V <br />