Laserfiche WebLink
I. SEVAGE (2) <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic systea comply with Ord. #549: Yea No Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: ---- <br /> Additional information or comments: <br /> r <br /> 2. WATER SUPPLY <br /> Is water supplied by priva a weYes No <br /> _ 1�Is well proper: Yes No <br /> ll: <br /> State deficiency: 0 7� 4 <br /> Does existing or proposed use make this well public water: Yes No <br /> Sample of well water taken: Yes No ` Date Taken Results <br /> (, <br /> 'Additional information or comments: r�,,� �� . ,� �.� f f�� !, ; � <br /> 3. GARBAGE &, REr'USE �O <br /> Licensed scavenger pick-up: Yes — '-- <br /> No Service Area No. _ <br /> Other proposed disposal method: <br /> Potential problem: _ <br /> 4. FLY, M)SQUITO OR VECTOR 1, ad TIAL <br /> State possible-vec potential & necessary control: W5U I-Q, <br /> 5. AIR PO LLU TION PO TEN TIAL <br /> State possible burning or p ocessing polutants & necessary control: <br /> u4' -3co sGYt,ap 15 UJ _ _ 'Qy <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: --' — Additional facilities needed _ <br /> 7. PREVIOUS OPERATION HISTORY <br /> M� 6c, a J UAK Lt 14 <br /> 8. GEiv-ERAL SANITATION J <br /> State any problems not previa ily noted: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq <br /> rMlf�l,n�.■ <br /> LH • 06 06 3/71 4/74 750 <br />