Laserfiche WebLink
/y <br /> 1 SEWAGE / <br /> Distance to Public Sewers Connection necessary : Yes No_ <br /> Does existing septic system comply with Ord . #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> State possible vector potentiFtl & necessary control: <br /> 5 . TOILET/BATH FACI_LJT— <br /> No . ez location existing : — Additional <br /> facilities needed _ <br /> 6 . PREYIQQ2 O RATIOi1 HIST(> i <br /> 7 . QENERAL SAtUTATI-M <br /> State any problems not previously noted : - <br /> 3 . <br /> oted : -3 . PI) ' ULATION DEH = <br /> Appx. No . People per rq. mi . <br />