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1 . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No_L <br /> Does existing septic system comply with Ord . #549 : Yes No_ <br /> Unknown If no, explain: <br /> De^s��ribe septic ns allat .on o be in8talled:-400 <br /> 2 . MATER SUPPLY <br /> Is water supplied by private wel Y s No Is,, well roper: <br /> Yes No,� State deficie gE l� ��- " , .•GG <br /> Does xisting or porposed use make this well pLiblic water: Yes <br /> Noe Sample of well water taken: Yes Noe Dat$ taken f <br /> Resui s /Additional information or comments �•c� <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No-4 Service Area No. <br /> Other proposed disposal method: <br /> Potential problerri :o,",c`­z'--f -e*0'GJ of 6.l�f E �.1� �e �O �l�E <br /> 4 . FLY . MOSQUITO QRy '" C_) PSMHZId1L <br /> State possible vector poke/ntifrl & necessary control : &�, O Fac <br /> 5 . TrOILET/BATH FACILITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION HISTORY <br /> 7 . GENERAL SAKI' `lam 'It_)N <br /> State any problems not previously noted: <br /> 4e•C�0ye- z f.-f F /J <br /> 9 . POPULATION DENISTTY <br /> Apex. No . P e o P 1 e per c . m <br />