Laserfiche WebLink
1. SEWAGE <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 /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes No _ Is well proper: Yes _ No <br /> State deficiency: <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: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: r-- <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: f Additional facilities needed <br /> 7. PREVIOUS OPERATI HISTORY . /. <br /> i <br /> b. GE14ERAL SANITATION <br /> State any problems not previously noted: 1 7-V-1101-«„t/ <br /> .. <br /> 9. FOPULATION DENSI +•� __,_,._ <br /> Appx. No. People per sq. mi. <br /> fc?" V10" 'Ikluz)0 <br /> y <br /> �y 7` �- C44401 <br />