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(Draw To Scale) <br /> SCALE " TO ' <br /> 1. Names of streets or roads nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. I <br /> s such as patios <br /> 3. Dimensioned outlines and locations of all existing and proposed structures,including covered area , <br /> driveways and walks. <br /> 4� Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <br /> 5. Location of other wells within radius of 75 feet on the property or adjoining property. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> r i <br /> OF K� <br /> I� <br /> O Ai <br /> I <br /> I <br /> T <br />