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SEWAGR <br /> Distance to Public Sewers Connection necessary: yes_ <br /> Does existing septic system comply with Ord . #1549 ; Yes No_, <br /> Unknown If no, explain: No_ <br /> Describe septic installation to 'be installed: <br /> 2. WATER SUPPr y <br /> Is water supplied. by private well : Yes �� i10 Is wellyes--� No State deficiency: Proper: <br /> Does existing or porposed use make this well public Water: Yes <br /> NO `="_ Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & RFFrUSE <br /> Licensed scavenger pick-up: Yes v� No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY MOSQUITO QR V ^TOR Pn'C NTTAT <br /> State possible vector potential & necessary control: <br /> 5 . TC7TLFT/BATH FACLTTE; <br /> No. & location existing: <br /> facilities needed Additional <br /> 6. PRRVTnn5 np9RATTON H STnRY <br /> ���C•(.l tn.p Y�'S <br /> 7 . GENERA T, SAt� TATTnN <br /> State any problems not previoLisly noted: /L C"-p <br /> g • Pnnrlr,AT7nia nF?i;TTV <br /> APpx. NO . People per sq . mi . <br />