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(2) <br /> Distance to Public Sewers ( Connection necessary: Yes _ No X `k. • 'I <br /> Does existing aeptic system comply with Ord. 4549: Yee No Unknown <br /> n <br /> Describe septic installation to be installed: P e a� <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> I 'vate&:supplied private well: Yes Ho X Is well proper: Yes No <br /> Sate deticiericy: Z- rp A <br /> /'t/14 C -P <br /> SDoes 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 comment;xV4 <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes _ No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR L-0TENTIAL <br /> State possible vector potential & necessary control: <br /> 5. AIR POLLUTION POTENTIAL / <br /> State possible burning or processing pollutants & necessary control: 5strit <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: /(/� Additional facilities needed <br /> 7. i'kc wows oi,L cATIOIJ HISTORY <br /> b. GENERAL SANITATION <br /> State a problems not previously no d: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. / <br />