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Distance to i'ublic 0ewers � Connection necessary: Yes [,o <br /> Does existing septic system comply with Ord. #549: Yes _ No _ Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> To 6.&,` ,- <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by pr iv to well: Yes _ Nod/ Is well proper: Yes _ ' o <br /> State deficiency: <br /> Does existing or proposed use make this well public water: Yes <br /> Sample of well water taken: Yes _ No ate Taken <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector poten ia1 fl necessary control ��WJ <br /> r b i' „o "A+ <br /> Q. Y- vro <br /> �. <br /> 5. AIR POLLUTION PO TETT TIAL O f I�'lT� of <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES �l. <br /> No. & location existing: 1 b !"'� ditional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> 8. GENERAL SANITATION <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. <br />