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6 Distance to i'ublic ,;ewers Connection necessary: Yes V_ 1,0 _ <br /> Does existing septic syste comply with Ord. #549: Yes Info Unknow _ <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> Additional information or comments:2. WATER WA`1'ER SUPPLY <br /> Is water supplied by private well: Yes J,,-' No _ Is well proper: Yes 1/ 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 i/Sate Taken Results <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes _ No Service Area No. <br /> ��kl <br /> Other proposed disposal method: -- <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State p ssible vector potential & ne essary control: r' <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 /> $. GENERAL SANITATION <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />