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1. SEWAGE (2) <br /> Distance to Public Sewers -9- Connection necessary: Yes No <br /> Does existing septic system comply with Ord . #549: Yes — No Unknown-' <br /> If no, explain: — — <br /> Describe septic installation to be installed: <br /> �1Uod <br /> � iZ6[� eZ —a:ke 4 i&oViC M�C�/� �G✓/tGi X00 /1ZN GCLritC� <br /> Additional information or comments: r <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes _ No ✓ Is well proper: Yes — No _ <br /> State deficiency: //V /- <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 /> Additional information or comments: 5A Aitl�^�s� �, vc�eNt <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes — No — Service Area No. <br /> Other proposed disposal method: ✓ /✓��l�xBui�Q <br /> Potential problem: /0142 <br /> 4. FLY, 'MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: Aw C <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: /*?t., Additional facilities needed "�/� <br /> 7. PREVIOUS OPERATION HISTORY <br /> b. GE14ERLL SANITATION <br /> State any problems not previously noted : 14014 <br /> 9. POPULATION DENSITY p <br /> Appx. No. People per sq, mi. �yira�zp�Gr�C Gic� <br />