Laserfiche WebLink
�orw � ate- . <br /> 1 . SEWAGE <br /> Distance to Public Sewers N� Connection necessary: Yes ti/ No_ <br /> Does existing septic system comply with Ord. 0549 : Yes No_ <br /> Unknown If no, explain: � <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes � clo Is well proper: <br /> Yes -�No— State deficiency: <br /> 6ae-114k <br /> Doeexisting or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Res its Additional information or comments <br /> 3 . GARBAGE & REFUSE, <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal meth d: <br /> Potential problem: <br /> 4 . FULl- MOSQUITO OR V �;'TO E4_TrMITali <br /> State possible vector potentiftl ?z necessary control : <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing: _ Additional <br /> facilities needed _ <br /> 6 . PREVTO172 OPERATTON H OF:Y <br /> 7 . QRN RAL sAPjTT,&TjON <br /> State any problems not previously noted: - <br /> 8 . <br /> oted: _8 . 'O ' 1LATION hENSTIv <br /> Appx. No . People per rq . mi . <br /> 14 <br /> r/0 <br /> z /,�,, 12�� / �� -7161 . <br />