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T- <br /> Distance to Public Sewers Connection necessary: Yes No_` <br /> Does existing septic system comply with Ord . #549 : `les No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2 . CATER SUPPL`I <br /> Is Ovate " supplied by private well : Yes iJv 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 /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . �� MOSQUITO QB V E^.TO E i'[EN_ TIAL <br /> State, possible vector potentiftl nece sary control : <br /> 5 . TQTLET/BATH FACILITES <br /> No . & location existing: Additional <br /> facilities needed _ <br /> 6 . PREVTOTTS OPERATION SO7 <br /> P <br /> r <br /> 7 . GENERAL SANIT '1.A 'I0N <br /> State any problem: not previously noted : _ <br /> 8 , F'OPULATTON DENISTTY <br /> Appx. No . People per rq. mi . <br /> (Ain s <br />