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1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No-2< <br /> Does existing septic system comply with Ord . #549 : Yes No <br /> Unknown If no, explain: <br /> Describe sep iq installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is water eupplied by private well : Yes i'lo-4- Is well proper: <br /> Yes No State deficiency : <br /> ,,rte,>� s/� ,�!/',�P- �j.�✓,��,- �., �,���` '�'4'/�.�f�_�,� <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date take <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 /> 4 . =_ - MOSQUITfi OR V Z^.TM) E iTT T?AILL <br /> State possible vector potentiFtl & necessary control : <br /> 5 . TQTLET/BATH FACILITES <br /> No . & location existing : _ Additional <br /> facilities needed _ <br /> 6 . PREVTOnS OPERATION H �X <br /> 7 . GENERAL SANI'rA'1'ION <br /> State any problems not previously noted : <br /> S . P- > II ATION DEN SITv <br /> Appx. No . People per 6q. mi . <br />