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( 2) <br /> Distance to ?ublic Sewers O-' Connection necessary: Yes No <br /> Does existing septic system comply with Ord. #549: Yes No Unknown ' <br /> If no, explain: <br /> Describe- -sep ns ation to be installed: <br /> Additional information or comments: V" <br /> 2. WATER SUPPL <br /> Is water supplied by private well: Yes _ No _ Is we 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 11esults <br /> Additional information or comments: L Jf <br /> 3. GARBAGE & REFZISE <br /> Licensed scavenger pick-up: Yes — No Service Area No. - le)e <br /> Other proposed disposal method: <br /> Potential problem: <br /> h. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary. control: <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: _ <br /> 6. MILET/EATH FACILITIES <br /> No. & location existing- Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> o. GENERAL SANITATION <br /> State any problems not previously noted : 0"o h-o <br /> Q <br /> r � - <br /> r <br /> 1-01'ULATIO?DENSITY <br /> Appx. i4o. People per sq. mi. <br />