Laserfiche WebLink
1 • SEWAGE <br /> Distance to Public Sewers Connection necessary : Yes No_ <br /> Does existing septic system comply with Ord . 31549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes coo Is well proper: <br /> Yes No State deficiency : �Gf� <br /> ' <br /> PC-11b4 <br /> j <br /> Does existing or porposed use make this well public water: YesX <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal ,ethod: <br /> % � <br /> Potential proble : f� ° <br /> mt <br /> 4 . FAL MOSQUITO OR V CTO ELi f rNTIAL <br /> State possible vector potentiftl Ft necessary control : <br /> 5 . TQI ET/BATH FACILITES <br /> No . ez location existing: — Additional <br /> facilities needed _ <br /> 6 . PRFVT0QS rPLR.ATION <br /> 7 . GENERAL SA L11A].'ION <br /> State any problems not previously noted :- <br /> 3 . <br /> oted :-3 . FJQ > 1TI014 DENSTTX <br /> Appx. No . People per oc3 . r,,i . <br />