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r: K S00V � �� ITY EVEI-OPENT DEPARTMENT <br /> I <br /> Y SIVE APPROVAL <br /> i.m$R• ;. O U N T Y• <br /> RLE DUMBER: <br /> SERVICES <br /> Water, <br /> Public Service Provider: Vdill Serve Letter Provide,. Distance to PUNIC'.Vater <br /> Prvale Existing Well Well Replacement <br /> Wastewater.Disposal <br /> Public Service Prov.cer. Will Serve Letter Provided Distance to Public Se a'er. <br /> ❑ ❑ <br /> Prfvate Existing Septic,Systerr New Septic System Septic System Repacement <br /> ❑ I] ❑ ❑ <br /> If t•ie project w.11 fes-.,It in process <br /> Description of process Volume of p-ocess wastewater Method of disposal: <br /> wastewater <br /> vrastevrater p:oviae the following <br /> Information: <br /> Storm Drainage <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Storm Drain: <br /> El <br /> Private Eriisting On-site Retention Pond New On-site Retention Pond Natural Drainage <br /> OTHER PUBLIC SERVICES <br /> School Service Fire'ProtectRbn Service <br /> Service Provider 1 Distance to School Service Provider Distance to Fire Station <br /> a <br /> Page 3 of 6 <br /> Updated 08,22,2019 <br />