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tis <br /> GLUNN <br /> � 1818 I'o.�L�4R��94 <br /> P1nBif 5RG, 432.42 � <br /> VICINITY MAP f415) <br /> Indicate below the exact location of well with respect to the following items: property lines,water bodies or water cou8esrr;}' <br /> drainage pattern,roads,existing wells,sewer main and laterals and private sewage disposal systems.or other src0;g0Co11Y 5� <br /> f" <br /> tamination or pollution. INCLUDE DIMENSIONS This is required inorder to o bfiain �►Ou�` g�1"m��t�.;4�Z EtxY �Y <br /> �• y�rj 69111 <br /> � a •f ° ° 4' Yea c- � <br /> - <br /> � <br /> 4 <br /> t <br /> l< r r <br /> 126 <br /> �, ice... �..�..��1�..�.. �/r���•� ,_ �-e -'r„_F <br /> +f <br /> ' ll� t+�... Q�►3�Z r� �'N d Q��.'�fcZU G�`�.©��`'`" ',,r t�-f;�:� <br />