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SEWACaR . - • <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic system comply with Ord . #549 : Yes _ <br /> Unknown If no, explain: _.aC No_ <br /> Descr:ibe eptic Installation to *be installed: �'� ,S/oy <br /> ; <br /> � 1 <br /> 2 . WATER SUPPr.Y <br /> Is water supplied by private well: Yes No Is well <br /> Yeses„ No State deficiency: Proper: <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 & REFUSR <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY. MOSQUITO OR VMOTOR PO'frNTTAL <br /> State possible vector Potential & necessary control: <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. PREVIOUS OPERAT ON H 4TCfRY <br /> 7. GENERAL SANTTATTON <br /> State any problems not previously noted <br /> 8 . POPULATION F.N3T jV <br /> Appx. No. People per eq. m i . ����<'���.�f �`�✓io�.�;��� <br />