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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 /> s � � (� <br /> 2 . MATER SUPPLY <br /> Is Ovate supplied by private well : Yes t1 No Is dell proper: <br /> Yes Q No State def/iciency : A r red► Z i :.d--4.j/P . <br /> irk � A � ✓�� X11 21P � �LU � <br /> Doeseting or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No_,;�-Irate taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licenced scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method:. <br /> Potential problem- <br /> 4 . <br /> roblem:4 . F11� MOSQUITO OR v12-TO PSITEiMIAL <br /> State possible vector potentiftl Fz necessary control : <br /> 5 . TOILET/BATH EACCIILITES <br /> No . & location existing : Additional <br /> facilities needed <br /> 6 . PREVIOOS OPERATION HISTngX <br /> Y <br /> 7 . GENERAL SAP�IT TJON <br /> State any problems do t previously noted- <br /> 8 . <br /> oted:3 . POPULATIO14 DENSITY <br /> Appx. No . People per rq. mi . <br />