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1. SEWAGE <br /> Distance to Public Sewers / Connection necessary: eyes No <br /> Does existing septic system comply with Ord, #549: yes. ` ' No ` Unknown <br /> If no, explain: , <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: yes .,�.• <br /> State deficiency: No — Is 1,111 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 Results ' <br /> Additional information or com cnts: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger. pick-up: Yes No _ Service Area No. <br /> Other proposed disposal methodz <br /> Pntenti -11 <br /> 4. 1,,Lx wSQUIM OR VEc:107t pon-, lTIAL <br /> State possible vector potential & necessary control: <br /> S. AIR POLLUTION POMITIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. m1LET/BA7({ FACILITIES <br /> Ivo. & location existing: <br /> 7. PREVIOUS OPERATION HIS MRY , Additional facilities needed <br /> r <br /> o. GENTMAL SANITATIO11 <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. 140. People per sq. mi. ?/`0. <br /> e. elF GIceEef� 1a 7 ` 4 . <br /> �9��F� '�3 /,r ya dFd�c�.®r�s�` �.s/e-�ft .d.�d�j��2 r✓� /,l�,a-✓ F�2a,Cirif�ee'r ��f,o.l���f <br />