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r ; <br /> t � . <br /> f SCALET'4�1 it TO <br /> tF} ZGundf 14 t - _ <br /> 1, Names of Streets or roads nearest to or"dn erbperty -..- <br /> 2. Outline of the property, glvr`ng=4ilrllel§goot~ °r(+ T�IO;t di �cti~ r € <br /> 3. Dimensioned outlines and locations ofiffmWin�t ptpposia#structures,including covered areas such aspatios, <br /> rivew ys pnd <br /> walk <br /> a,disposal.sy-Stemgr_.proPQS��f, age S1i�i?���►�� ems <br /> proposed expansion of sewage disposal system, o any other possible source of contamination. F s.bt .i <br /> 5. Location of:other Wells within radius of 150 feet on the property orsd)oininq,property <br /> fi. Locatio.ri-of sewage disposal system on adjoining property or-within.a radius of 150„f et <br /> Jll <br /> LC <br /> Iq <br /> -� <br /> L <br /> t <br /> 1 <br /> 1 } <br /> a I <br /> I <br /> _e <br /> it <br /> I so <br /> • �� ra skx ;ei.-- - - <br /> pp <br /> E ' <br /> b I � <br /> i <br /> , <br /> _E <br /> i I <br /> E <br /> - -- -�- fi . <br /> .r <br /> l ` <br /> FF _.. r ......... _._._._ ; <br /> F <br /> - , _ <br /> I � I <br /> I <br /> j <br /> F <br /> , <br /> I <br /> s E <br /> i.._ <br />