Laserfiche WebLink
1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No-- <br /> Does <br /> o_Does existing septic system comply with Ord . 0549 : Yes No--- <br /> Unknown <br /> o_Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency : <br /> Does existing 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 /> 3 . GARBAGE €i REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . =,_ MOSQUITQ OR VEQTQR 'PO f ENTIAL <br /> State possible vector potential & necessary control : <br /> 5 . TOILET/BATH FACIA TES <br /> No. & location existing: Additional <br /> facilities needed _ <br /> 6 . PREVTOPE OPERATION HISTORY <br /> 7 . GENERAL QUIT, TION <br /> State any problem: not previously noted:-- <br /> 8 . <br /> oted:_8 . NPULATION DENaITy <br /> Appx. No . People per sq . mi . <br />