Laserfiche WebLink
1 . SEWAGE <br /> Distance to Public Sewers IOZA Connection necessary : Yes No-L <br /> Does existi g septic system/ comply with Ord . #549 : Yes No— <br /> Unknown <br /> o_ <br /> Unknown=If no, explain : <br /> Describe eptic installation to be installed: <br /> �•f s �e <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes �i3o Is well proper: <br /> Yes I No State deficiency : <br /> Does e�s� sting or porposed use make this well publ c water: Yes <br /> No ✓ Sample of well water taken : Yes No---Z taken <br /> Results Additional information or comments <br /> 3 . & REFUSE <br /> License scavenger pick-up: Yes No Service Are"o . <br /> Other pro sed disposal method : <br /> Potential p blem: <br /> 4 . FLY VECTOR POT !,NTIAL <br /> State possible ve for potential & necessa control : <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing : Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION—HI—STC <br /> 7 . <br /> State any oblems not Previously noted : - <br /> 3 . <br /> oted : _3 . POPULATION DF"IS I Tom' <br /> Appx . No . People per sq . mi . _ <br />