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(2) <br /> 1. SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes _ No <br /> Does existing septic system comply with Ord. #549: Yes _ No _ Unknown <br /> If no, explain: / ZI.- <br /> Describe septic installation to be installed: <br /> Additional information or comments.- <br /> 2. <br /> omments:2. WATER SU PLY , <br /> Is water supplied by private Drell: Yes v No _ Is well proper: Yes — No <br /> State deficiency: AJ).11 <br /> Does existing or proposed use make this well public water: Yes _ No <br /> Sample of well water taken: Yes _ No _ Date Taken Results <br /> Additional information or comments: U X Z_ <br /> 3. GARBAGE & REFUSE c� , / /e, ? '� 1 <br /> Licensed scavenger pick-up: Yes _ No Service Area No. <br /> Other proposed disposal method: 1J , <br /> Potential problem: /L G , -? <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> � JZCI r'f <br /> 5. AIR POLLUTION POTENTIAZ <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> 8. MZRAL SANITATION <br /> State any problems not previously noted: <br /> 9. FOPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />