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Distance to Public Sewers Connection necessary : Yes_= No_ <br /> Does existing septic system comply with Ord . 0549 : Yes— No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: ✓� t� `F <br /> 2 . WATTSUPPLY <br /> Is water supplied by private well : Yes _ No_ Is well proper: <br /> Yes— No_ State deficiency : <br /> Does existing or porposed use make this well public water: Yes <br /> No_., Sample of well water taken: Yes_ No_ Date taken <br /> Results Additional information or comments <br /> S . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes— No_ Service Area No. <br /> Other proposed disposal method: <br /> Potential problem:_,_ <br /> 4 . FLY . MOSQUITO OR VROTOR POTENTTAI, <br /> State possible vector potential & necessary control : <br /> 5 . TOILET/HATH TFACT1,TTES <br /> No . ek locution existing: /� rG3 Additional <br /> facilities needed <br /> 6. PREVIOUS OPERATION HISTORY <br /> Vi � <br /> 7 . GENERAL SANITATION <br /> State any problems not previously noted : <br /> S . POEUL.ATION DFNSI_TY <br /> APpx. No . People per sq. mi . <br />