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(Draw To Scale) <br /> SCALE- __ .„ T�_--------*-------- - _----...--- ---------- ---__ _�--__.' <br /> 1. Names of streets or roads nearest to or bounding the property. <br /> 2' Outline-ot*the property,'giving dimensions and North direction. . <br /> 3. Dimensioned outlines and locations of all existing and proposed structures;including coveriederees such as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or'proposed Sewage disposal system, <br /> roposed exp nsion of sewage disposal system, or any other possible source of.contamination. <br /> 5. Location"of'olher wells within radius'of 75 feet on the property or adjoining property. <br /> 6. Location of sewage disposal system on adjoining property or %kithin a radiusof 150 feet. <br /> -TFi <br /> 5 <br /> _ 5 <br /> 4 <br /> Rr <br /> k <br /> 1p o <br /> U <br /> O <br /> d <br /> 3 <br /> No, <br /> r <br />