Laserfiche WebLink
1. SEWAGE <br /> (2) <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic system comply with Ord . #519: Yes No Unkno_wn <br /> If no, explain: <br /> Describe septic installation to be installed: , , <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes _ IJo Is well proper: Yes _ No _ <br /> State deficiency: ��c-,� s <br /> Does existing or proposed use make this well public water: Yes No <br /> Sample of well water taken: Yes No Date Taken Results L , <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE XNo <br /> Licensed scavenger pick-up: Yes _ Service Area No. <br /> Other proposed disposal method : <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> J- <br /> State possible vector potential (Sc necessary control: A- <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: �' � ✓ <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: , lei Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> b. GENERAL SANITATION <br /> State any problems not previously noted : <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq, mi. <br />