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SEWAGF <br /> Distance to Public Sewers Connection necessary: yes <br /> Does existing septic system comply with Ord . #549 : `Ies No_ <br /> Unknown If no, explain: No_, <br /> Describe septic installation to 'be installed: <br /> 2. WATER SUPpLy <br /> Is water supplied. by private well : Yes No Is well <br /> Yes No State deficiency: Proper: <br /> Does existing or porposed use make this well public water: Yes <br /> No_ , Sam <br /> Ple of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & RFFUSF <br /> Licensed scavenger pick-up: Yes L No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 • ELY MnRQ"TTn no VTOTnR 20grENTT e r <br /> State possible vector potential--c necessary control: <br /> J\j a '' <br /> 5 . TQT ,FT/BATH FArTT,TTF 3 <br /> No. & location exioting: <br /> facilities needed Additional <br /> 6. PRRVTons nPRRATT0N uT^TngX <br /> j <br /> 7 . GENrRA , 2ANTTAT7n4 <br /> State any problems not <br /> Previously noted : /t! <br /> S . PnP[Ii,A'^TnN T3^�5*;TTV <br /> ' Pecple pe. Q <br /> APPx. Igo . � -1 <br /> Q . iii . r (s �O�'rti� lc✓ <br />