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i . SEWAGE <br /> Distance to Public Sewers NLS Connection necessary: Yes No'' <br /> Does existing septic system comply with Ord. #549 : Yeses No <br /> Unknown- If <br /> no, explain: ( l <br /> ��i✓lr-C2 Lt. .S;L....l C -- CLIv - I�QC�(!I-Z _ / f � Al- <br /> Describe septic installation to 'be insta lid: <br /> 2 . LATER SUPPLY <br /> Is water supplied by private well : Yes � ':Io Is well proper: <br /> Yes .i No State deficiency: <br /> Does "isting or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> ! r <br /> -�4 61 <br /> a <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger ick-up: Yes No Service Area No. <br /> Other proposed dispos 1 method: <br /> Potential problem: <br /> 4 . FLY. MOSQUTTO OR YR-TOR �,vT.j,-NTTA , <br /> State possible vector potentirtl & cessary control: <br /> 5 . TOILET/BATH FACTLITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6 . PRFVIOUS OPERATIOM HISIORY;, <br /> 7 . GENERAL SAITTTATION <br /> State any problems not previouSoly noted: <br /> 8 . POPULATION DENSTTY <br /> Appx. No. People per sq. mi . <br />