Laserfiche WebLink
1 . <br /> SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No v <br /> Does existing septic system comply with Ord . #549 : Yes ✓ No_ <br /> Unknown If no, explain: <br /> t <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private ;cell : 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 /> .� Q r <br /> 3 . G=ARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . =,_ MOSQUITQ OR V QTO PC'fLjjT Du <br /> State- possible vector potentiFtl & necessary control : <br /> ' r <br /> 5 . TOILET/BATH FACILITES <br /> No. ec location existing: _ Additional <br /> facilities needed _ <br /> 6 . PREVIOUOP ,RATION HISTO r <br /> 7 . GENERAL 2At1ITA' L(—) <br /> State any problems not previously noted: - <br /> 3 . 1;'MMATION D NSTIX <br /> Appx. No . People per req . m i . <br />