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POT PIAN `- <br /> i <br /> (DrAN To Scale) , <br /> Y.. AL"kALE: II TO . ,. <br /> i 1. Names of streets or roads nearest to or bounding the property. r'S <br /> 2. Outline of the property, giving dime'nisioris and North direction.. <br />[ 3. Dimensioned outlines and locations of all existing-and proposed structures,including covered areas such as patios, <br /> I :.:driveways and,walks. <br /> 4, Location of house sewer outlet, public sewer, sewage disposal system or'proposed sewage disposal system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination:' <br /> 5. Location of other wells within radius' f 150 feet can the property oradjoiningpro'erty.r <br /> 6. Location of-sewage disposal systemwoh adjoining property or withrn�a r4diJs`of,150 feet. ^' <br /> n, r <br /> i <br /> s '§ <br /> �' •I I - r��.. .kms' <br /> Y <br /> 1 <br /> I -- - - � <br /> _ <br /> , <br /> 1 <br /> AT�' ;:i ti� 'k Y.k 'i,L,- '. -'ite ..tiS ';' si. _ ,. I •..?.. �i4 <br /> I <br /> _ tr �} lei �r � '� 'Z. •A. c �� 'F -. _ � .P.-n l I: .. <br /> •P � -ti i __ <br />