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V,.1 ''i irkgl§ ald? :. ,d� k•N.ra... „"..'°"""''"""E`�.. <br /> ' ,�t�� �.,yfE.�r A U��T,:4'�'E„SFr ��'4 • � -'�b ,' 9"�� 5.j� <br /> s 1. Names of streets or roads nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction: f :' <br /> I Dimensioned outlines and locations of all existing and proposed structures,including covered areas such as patios,, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination <br /> 5. Location of other wells within radius of 75 feet'on the'property or adjoining property. <br /> 6. 'Location,of,sewage disposal system on adj6hIfng\property or within a radius of 150 feet. ' <br /> 77 <br /> , .� <br /> 1 I L <br /> ... .t. + <br /> iI <br /> i <br /> �-- - - - <br /> - - r- <br /> ■ <br />