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(2) <br /> 1. SEWAGE <br /> a <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: I Ad <br /> Describe septic installation to be installed: <br /> A ditional information or comments: <br /> 2. WATER SU FLY <br /> Is water supplied by private well: Yesy No Is well proper: Yes _ No <br /> /State deficiency: r <br /> Does existing or proposed use make this well public water: Yes No 03 <br /> Sample of well water taken: Yes _ No Date Taken Results <br /> Additional information or comment <br /> l �j/ �to 11 AW1�-- , <br /> 3. GARBAGE & REFUSE � el�s: <br /> ' / ? r J,h 'o V GL�� <br /> Licensed scavenger pick-up: Yes _ No Service Area No. <br /> Other proposed disposal method: u <br /> F�otential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> J <br /> i <br /> 5. AIR POLLUTION POTEITI <br /> State possible jburning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY , <br /> GENERAL SANITATION <br /> State any problems not previously noted: <br /> 9. FOPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />