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fx : LOT,: PL" <br /> � <br /> . <br /> (DRAW TO SCALE):: <br /> -- <br /> SCALE r,' rr `LO v . <br /> 1. Names of streets or roads Weare � • ' ;- - " <br /> ra ert nearest to or bounding the Property� . <br /> 2. Outline of the <br /> P P y, giving., dimensions-and:North direction. ' <br /> 3. Dimensioned outlines and locations of all„existing and proposed structures, including , <br /> covered areas. such as Pafiosy driveways and`'wal.ks..' <br /> 4. Location of house sewer outletv 'public' sewe <br /> disposal systemr,'sewage disposal system or proposed sewage <br /> , proposed expansion .of sewage disposal s <br /> source of contamination.' ystem,.or any other possible <br /> -� <br /> 5. Location of other well s. within•radius of 75 feet on the property oir adjoining property. <br /> 6. Location of sewage disposal:-system on. ad oinin <br /> ,' g proper[y .or'within .a• radius of 100 feet. <br /> _ . . <br /> : <br /> } <br /> , <br /> , <br /> _ - <br /> , <br /> i, <br /> : <br /> , <br /> ...._ <br /> -. <br /> i <br /> _. T <br /> ... . <br /> i <br /> , <br /> :_ <br /> _.. <br /> .......... <br /> {------ --- <br /> ti=r / <br /> . xr <br /> x <br /> .w <br /> - _.. <br /> .. .. __ __ <br /> , <br /> I <br /> , <br /> r <br /> • .,-r <br /> .......:....................... <br /> ' •4 <br /> I <br /> : <br /> , <br /> -- -•,- <br /> f- <br /> i..__...l._...__{.__....{ { , <br /> ; <br /> : <br /> "-I <br /> ' _. <br /> :x <br /> I <br /> • <br /> . <br /> : <br /> 7 <br /> -------------- <br /> -".-OAS <br /> ' <br /> ui " oc• L <br />