Laserfiche WebLink
(2) <br /> 1. SEWAGE <br /> Distance to i'ublic Sewers ��� Connection necessary: Yes _ No S( <br /> Does existing septic system comply %.rith Ord . W-�i,9: Yes _ No _ Unknown _ <br /> If no, explain: -�— / <br /> P1-z S /Grp-i l C'UJ `t�T? <br /> Describe septic install atiodJto be installed: I�A_fj <br /> Additional information or comments: ?� <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Ye:; _ l;o Is well proper: Yes _ No _ <br /> State deficiency: <br /> Does existing or proposed use make this, well public water: Yes )�— NO _ <br /> Sample of well water taken: Yes 110 Date Taken Results <br /> Additional information or comments: <br /> 3. GARBAGE & REYU SE / <br /> Licensed scavenger pick-up: Yes _ No Service Area No. / l <br /> Other proposed disposal method : <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR. VECMR P012.NTIAL <br /> State possible vector potential & necessary control: <br /> $. AIR PO LW TIb;4 POTI•J l TI A L <br /> State possible burning or processing pollutants & necessary control: /f/(_? � <br /> 6. 'IUI1ZT/BA11{ FACILITIES <br /> Igo. & location existing: r..9cez, Additional facilities needeo <br /> 7. rf&LVIOUj UI•c.rtA'rIOI4 <br /> 4 <br /> b. GEI:>✓RAL SAldl'rATION <br /> State any problems not pruviuu;;ly no*,.,..i : <br /> 9. FONULA'rIUI4 DENSITY <br /> AI)px . 14o . I-copl c per :.q. r., <br />