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I <br />41 <br />4 <br />PLAN <br />(Draw TO Scale) <br />�,,SCALS—" TO <br />1, Names of streets or roads, nearest to or bounding the property. <br />2. Outline of the property, giving jirensioiis and North direction. <br />3. Dimensioned outlines and locations of all existing and proposed structures, including covered areas 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 />proposed expansion of sewage disposal system, or any other possible source of contamination. <br />5. Location of other,wells within radius of 150 feet on the property 6r adjoinijog propetty.-.— <br />-.6. Locatioriof di"gekisp6sal syst;f46n-4djoining prope&y`-6'r'Witfi`ih-A raifi'U--8`of,1M'-f"t. <br />AJ I-V VA, a L— <br />'� i 112� <br />T <br />47 <br />4. <br />71r <br />tit <br />—1* <br />-A <br />Ore. <br />4 <br />4 <br />ii <br />-4- <br />.h <br />hl <br />ft <br />_Jt <br />IM <br />-4- <br />r <br />d- <br />.4 <br />