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,- <br /> PLOT <br /> ............ <br /> PLOT PLA-LN <br /> (DRAW TO SCALE) <br /> SCA11F --FP TO <br /> 1. Namea of str,cets or roads nearest to or bounding the property. <br /> 20 Outline of the property, giving dimensions and North direction. <br /> 3e Dimenslonf-d outlines and locat-lons, oE all existing and proposed structures, including <br /> covered areas such as patios , driveways and walks, <br /> Location of house newer outlet , public sewer, sewage disposal system or proposed sewage <br /> disposal system, proposed expansion of sewage dieposal system, or any other possible <br /> source of contaminatlon. <br /> Location of other wells within radius of 75 feet or, the property or adjoining property. <br /> Location of sewage disposal systei',i oi,, adjoining property or within a radius of 100 feet. <br /> rt <br /> .......... <br /> .... ....... ........... .. .:................ <br /> j. .......... .. .......... -- ---- ....... <br /> ................... .. . . ... ...... .... - .- . ....... ........ <br /> ............ ....... <br /> .......... <br /> .................. <br /> ........ .... <br /> ............. ..... . .................. <br /> -- ----- ------------ - <br /> .... ...... <br /> ... ........ . ...... <br /> A4- <br /> . .. . ... ...........- . ..... ....... <br /> ry <br /> ........... <br /> ........... ...... <br /> ........... ....... ....... .............. <br /> ...... ......... ...... ....... ..... . ...... ......... <br /> .............................. ............... ........... <br /> ............. .. .... ....... ....... ....... ............... <br /> ..... ........ ....... .. .... ....... ........ ..... <br /> ................. ........ ........ <br /> ............ <br /> ............. ...... ....... <br /> -?7 - <br /> ............... <br /> ........... ...... ....... ....... ...... ...... <br /> ............... ........ ...... ....... <br />