Laserfiche WebLink
1. SEWAGE <br /> Distance to Public Sewers /L/�ir Connection necessary: Yes }'" No _ <br /> F <br /> Does existing septic system comply with Ord. #519: Yes _ No Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: ' <br /> c ;, <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes _ No k 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: G�, ? �'r i✓ /�l �/ d �i � <br /> e <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 PO LLU TION PO TEN TIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. ZUILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY . <br /> �. GENERAL SA14ITATIO14 <br /> State any problems not previously noted: <br /> 9• POPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />