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4. <br />Location of sewage disposal system <br />•..- ; <br />5. <br />6. <br />1. <br />2. <br />3. <br />H.i <br />K-. <br />Names of streets or roads nearest to or bounding the property. <br />Outline of the property, giving dimensions and North direction. <br />Dimensioned outlines and locations of all existing and proposed structures, Including <br />covered areas such as patios, driveways and walks. <br />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 />Location of other wells within radius of 75 feet on the property or adjoining property. <br />i on adjoining property or within a radius of 100 feet. <br />PLOT PLAN <br />(DRAW TO SCALE) <br />SCALE f" TO /£>&' <br />b <br />■f...... <br />i <