Laserfiche WebLink
1. SEWAGE <br /> Distance to Public Sewers , <br /> Does existing septicConnection nocessary: jes No <br /> If no, explain: system comply with Ord, N549: Yes• No ` Unknown <br /> Describe septic installation to be installed: <br /> 7,� � <br /> Additional information or comments: <br /> 2• WATER SUPPLY <br /> Is water supplied by private well: YesNo - - <br /> State deficiency: "'-►- — Is well Proper: Yes No <br /> Does existing or proposed use make this well public water: Yes <br /> Sample of well water taken: Y03 No �✓ <br /> ___.. No Date Taken <br /> Additional information or Results <br /> comments• �y� �G <br /> 3. GARUrE & REFUSE <br /> Licensed scavenger. pick-up: YesNo <br /> Other Proposed disposal Service Area No. <br /> po,,al method: <br /> Potential problem: <br /> 4. FLY MOSQUITO OR VECMR, POTINTIAL <br /> State possible vectorpotential & necessary control: <br /> s. AIR POLIATION PoMITIAL <br /> State Possible burning or processing pollutants & necessary control: <br /> 6• TOILEMUM FACILITIES <br /> Ivo. & locution existing: ' <br /> ?• RYAdditional facilities needed <br /> PREVIOUS' OPERATION HISTn <br /> o. <br /> GEVE RAL SANITATIO11 <br /> State any problems not previously noted; <br /> 9. FOPULATIO14 DENSITY <br /> APpx• i1o. People per sq. mi. <br />