Laserfiche WebLink
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: Yea No Date taken <br /> Results Additional information or comments <br /> 1 <br /> 8 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLY, MOSQUITO OR VZ n perENTIAL <br /> State possible vector potential & necessary control: <br /> 5 . TQTLET/BATH FACILITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6. pREVTORS opERATToN HISTORY <br /> 7 . GENERAL SAITTTAT ON �C � <br /> State any problems not previously noted:1-8 _ <br /> i <br /> 8 . POPULATTON PrUZZj -- r <br /> Appx. No. People ,.P . eq. m'... <br /> ..........,_.,w —" <br />