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a ;x '"' i <br /> A <br /> 4. <br /> SCANNED <br /> J1 OW <br /> SKM <br /> Distance to' Public Sewers Connection necessary: Yes Na_,, <br /> isst <br /> Does ,existing septic system comply with Ord. #549 : Yes No- <br /> unknown If no,` explain: <br /> �+r <br /> Describe septic instal ion to 'be installed: <br /> U4P � S 7,s <br /> 2. MATER SUPPLY . <br /> Is water supplied by private well: Yes -hbf well proper: <br /> Yes No State deficiency <br /> Does existing or porposed use make t1lis well public water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> . l.[��rp,�.p ��,s �-°.r!�"r'� � r► arerw 'ZcJ C/ � L O G e.yG'c� <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up:' Yea No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. ECTfIR 2ANTIAL <br /> State possible vector potential & necessary control: <br /> 5 . T0Qjr,ETiBATx £ArIEjTES <br /> No. & location existing: Additional <br /> facilities needed <br /> s. nn r, n Q <br /> ' F <br /> 7. GESERAL SANTTATTON ---� <br /> State any problems noted: <br /> 3 . pfIPULATIOtd DR STDRHSIT� <br /> Appx. No. People per sq . mi . <br />