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v wI <br /> � (Draw To Scale) � <br /> C SCALE TO <br /> 1. Names of streets or roads nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. <br /> 3. Dimensioned outlines and locations of all existing and proposed structures,including covered areas such as patios. <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <br /> 5. Location of other wells within radius of 150 feet on the property or adjoining property. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> b I <br /> m � i <br /> s <br /> -61 • o`�C� l <br /> Ra 5h • <br /> v� <o _ I: $ e <br /> - <br /> 11-619 as<lls <br /> loPofel N dl V� <br /> w;` 6� <br /> p t 1 <br /> Z <br /> d <br /> W <br /> 0- <br />