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SRWAGE <br /> Distance to Public Sewers "''I< Connection necessary: Yes_ Nom <br /> Does exist ng septic system comply with Ord. #549 : Yes_ No_ <br /> Unknown If no, explain: <br /> /l)0 c ",4s 4,V 4 le <br /> Describe septicinstallation to be installed: <br /> Tv 3e S.t'e of a f lam dadr . <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes �o_ Is well proper: <br /> Yes_ No_ State deficiency : <br /> Does existing or porposed use make this well public water: le P ' <br /> No Sample of well water taken: Yes_ No ✓ Date taken A <br /> Results Additional information or comments <br /> /UGo.J // 44-ve L r . Sztj, Gc cl a //< 4ae ct- /UGuJ-f� <br /> 3 . GARBAGR & RRFUSF. <br /> Licensed scavenger pick-up: Yes— No_ Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY. MOSQUITO OR V aTnR PLerFMTTA . <br /> State possible vector potential & necessary control: <br /> 5 . TOILET/BATH FACILITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6 . PREVTOUS OPRRAT ON H STORY <br /> 7 . GENERAL SANITATION <br /> State any problems not previously noted: <br /> '04-101–t <br /> 9 . POPULATTOt7 DENSITY <br /> Appx. No . People per eq . mi. <br />