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���� ���� Y <br /> ' <br /> ' <br /> (Draw TmScale) <br /> ' SCAUE ------^ TO-�_---' <br /> I. Names of,streets or roads nearest to or bounding the property. � <br /> 2. (J�d1he7� th�' -'' r�^ `v���||hi���ionsand <br /> . ' .. °� ~ ��_ . ="~`"".. � � <br /> 3` DinxensipnedouUineoand locations ofaU ��i ���� <br /> w^ n»~.."p .mo|udinQcc�oied)�eo�ou6h��n�tion <br /> dhvevvoymand vvo|ko. ' '-~����`� . � ' <br /> 4_ Location of house sewer out|et, public sewer, sewage d|spnom| system or <br /> ' -ga disposal system, <br /> proposed expansion of sewage disposal syntom, urany other possible aou ' - <br /> 5. LocmUunnfother vveUowithin radius of76feet onthe proped ~ypradjminin�--� -|-�-''--nation. / <br /> O. Location ofsewage disposal system on adjoining pnmpe�yorvvithin a radius ~�f '--' � <br /> ^" feet, l <br /> " '0 <br /> 7" <br />^ < <br /> / <br /> � <br /> � <br />