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SEWAGE 5�# 1 fir:3 3 <br /> Distance to Public Sewers Connection necessary : Yes No_ <br /> Does existing septic system comply with Ord . #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed : <br /> 2 . WATER SUPPLY ` � - <br /> Is wate supplied by <br /> private well: Yes �--- too Is well opex: <br /> Yes, No � iciEncy :�t ?J !J "'' � � CZAJeZI - <br /> � <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 . FLY„ MOSQUITO OR y ^. PrLNTIAL <br /> State possible vector potential & necessary control : <br /> 5 . TQ /BATH FACILITES <br /> No . & location existing : — Additional <br /> facilities needed <br /> 6. PREVIOUS OPERATION HISTORY <br /> -roe 2,0 Z' <br /> 7 . GENERAL SANITATION <br /> State any problems not previously noted : <br /> 8 . POPULATIQJJ-DENSITY <br /> Appx . No . People per sq. mi. _ <br />