Laserfiche WebLink
1 <br /> 1 . Sr,WAGE <br /> Distance to Public Sewers 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 /> Ad onal '.nformatio�r comments: ` �U�1 n <br /> �1/rl .(/(,. "'T / {�. ( 1" ✓ 1 D •J/ Ate! <br /> ddd + e <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes _ No _ Is well proper: Yes _ No <br /> State deficiency: <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: (//L <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes _ No _ Service Area No. <br /> Other proposed disposal method: <br /> Yo`�ia Problem: u vm Gni <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: , <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. i3REVIOUS OPERATION HISTORY <br /> ��r"o�� , <br /> GENERAL SANITATION <br /> rj State any problems not previously noted : <br /> 9. hOk'ULATIUN DENSITY <br /> Appx. Wo. People per sq. mi. i <br /> cl Uy tv z-r <br />