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JJ <br /> v .3 Gam. 4-7 � <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 %/O✓1 ' / <br /> Is water supplied by private well : Yes do 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 L_ <br /> le <br /> 3 . GARBAGE & REFUSE 4 Ff <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem <br /> ' ' . +' 2,/L T v� e _ j--�•.�� <br /> 4 . FLY , MOSQUITO OR YzC) pSrrNTT A L <br /> State possible vector potentiftl necessary conrol: TXP <br /> 5 . TnT_LET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6 . PREVTOnS np tiRATIGN HISTGgX <br /> Zoe <br /> gr 1f r <br /> 7 . GENERAL SANT'L TA tON 4•- <br /> State anyproblems notpreviously noted..—d /V <br /> T <br /> 10 e,21 ea 't� 7/\-0 y � rim w s <br /> - n•an..w, / /1 <br /> ARR No Peopleri'�37..A- <br />