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PLOT PLAN ' <br /> (DRAW TO SCALE) <br /> SCALE �� -TO' iIp <br /> -Names of streets or roads nearest to or bounding the property: _ - - <br /> ;2. Outline of the property, giving dimensions and .North direction. <br /> 3. Aicien-s'ioned outlines and Locations of all existing and proposed structures,`ii cluding <br /> 'I - covered areas such as patios, driveways and walks. <br /> °4. Location of house sewer outlet, public sewer, "sewage "disposal#.system or proposed sewage' <br /> disposal system, proposed expansion of sewage disposal system; or' any other possible <br /> source of contamination. <br /> 5. Location of other wells within radius of 75 feet on the property or adjoining=property. • <br /> f6. Location'of sewage disposal system on adjoinigg property—or within A radius of 150 feet. <br /> °E <br /> I _ x.�-as": -ai� __ _ -,�'LY��-Ke.:, qFT ..- -�� G�� .•'� -�-Ww6= .�' <br /> -------------- <br /> w <br /> AI <br /> z i <br /> W <br /> } <br /> C + .,.. ,..`-...... . . <br /> .� Y 1 Y19 9 t 1. <br /> I° . HEAL DISTRIC <br />