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1 . S�if3A�aE <br /> Distance to Public Sewers Mali- Connection necessary: Yes.,No <br /> Does existing septic syst m comply with Ord. #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic /installa ion to -be installed: <br /> 2 . WATER SUPPLY <br /> Is war supplied by private well : Yes _-"�No_ Is well proper: <br /> Yes_ No— State deficiency: <br /> Does ex sting or porposed use make this Well pint water: Yes <br /> No Sample of well water taken: Yes_ No_ Date taken <br /> Results Additiona/l' information or comments <br /> �C'/G��( �OV2✓ G�.(OIC G. LFJI�� <br /> U <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes_ No_, Service Area N . <br /> Other proposed disposal method: <br /> tential problem: <br /> 4 . FLY , n9QTjTTQ OR V11QTQR PS)P .NTIA <br /> State p sible vector potential & necessary •ontrol : <br /> 5 . <br /> No. & location exist Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION HISTQEM <br /> 7 . GENERAL SANI <br /> State anypro ems not previously noted: <br /> 8 . POPUT, TON DENSITY <br /> App No. People per sq. mi. <br />