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r <br /> 3 <br /> Distance to Public Sewers Connection necessary: Yes NOV <br /> Does existing,. septic system comply with Ord. #549 : Yes. No_,_. <br /> Unknown_` I no, explain: <br /> Describe septic installation to 'be installed: <br /> 2, SER SUPPLY <br /> Isw ter supplied. by private well: Yes Y No Is well proper: <br /> YesM No State deficiency: <br /> Does existing or porposed use make tilis well public water: Yes <br /> No7. Sample of well water taken: Yes ^ Na Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & ESEUSE <br /> Licensed seavenaer pick--up: Yes-y— No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: .tEE = <br /> 4. FLY, MOSQUITO 4R-Y- lQTf}R EXENTIAL <br /> State possible vector potential & necessary control: <br /> 5 . TQ 117 RT/BATH ,FAC I E TES 1� <br /> No. & location existing: Additional <br /> facilities needed...=n-V - <br /> 6. EREVIQUS QERRATTON HISTORY <br /> 7. GENERAL SANTI:AITON <br /> State any problems not previously noted: <br /> S . PPOPULATION DENST_TY <br /> Apex. No. People per sq. mi. <br />