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(Draw To Scale) <br /> v SCALE " TO <br /> 1. Names of streets or roads nearest to or bounding the property. <br /> T Outliv e of tf e property,-giving'dimensions and North direction. <br /> 3. Dimensioned outlines and locations of all existing and proposed structures,including covered areas such as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal systemor p'roposed-sewage disposal system, <br /> r, <br /> proposed.expansion of sewage disposal system, or any other possible source of 'contamination. <br /> 5. Locatiorf'of other wells within radius of 75 feet on the propertyoradjoining property. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> L <br /> NIS <br /> j <br /> / ' <br /> yy rf <br /> I Ar <br /> V <br /> ` D . <br /> r <br />