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1. SEWAGE, <br /> Distance to Public Sewers , ;:r, �• •� <br /> Does existingseptic Connection Ord. <br /> If <br /> Yes _ No.-! <br /> p system comply with Ord. #549: Yes. __._. No _ Unknown <br /> Irnyoy, explain: �• ,�, • <br /> Li <br /> DyiWd" insTatboon d'installad: ''� i� .ef�✓:� f <br /> Additional information or comments: <br /> 2• WATER SUPPLY <br /> Is water supplied by privato wolf; Yes ..... <br /> State deficiency: NO Is well proper: Yes No <br /> Does existing or proposed use make this well public water. Yes <br /> Sample of well water taken: Yes No <br /> No J/ Date Taken Results <br /> Additional information r conments:4/,�e,�,►.,,rG' <br /> 3. <br /> GARBAGE do REFUSE ��`.1 .y Q�9a/i D e E r 9�oT �°,c'i�✓4/�f.P f���F`�`�.�� <br /> Licensed scavenger pick-up: Yes >( No <br /> Other proposed disposal s method; '-`-� Service Area No. <br /> Potential problem: <br /> 4. <br /> FLY11 MOSQUIM OR VECMR POTENTIAL <br /> State possible vector potential & necessary control: <br /> S. AIR PO LLU TION POM TIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. miLET BATT{ FACILITIES <br /> No. & location existing: <br /> ?• PREVIOUS OPERATION HISTORY , Additional facilities needed <br /> 8. GEtaERAL SANITATIO11 <br /> State any problems not previously noted: <br /> 9. FOPUTATIO14 DENSITY <br /> Appx. U0. People per sq. mi. <br />