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1 . SEWAGE <br /> Distance to Public Sewers d�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 in alled:6f/Y- ,zio <br /> is - ✓ .l%�,C� �G�r/ia�c y ��E- <br /> 2 . DATER SUPPLY <br /> Is water supplied by private well : Yes _ Nom_ Is well proper : <br /> Yes_ No_ State deficiency: <br /> /l'l z4" 4*1 Ae<'E.l 7c ':"r. <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�E�t��Ea«��,��� <br /> � ��/9s1��f.p�sr-��1f��C�er�,.<:,✓ory y �Fr�rvEl lyo�.re�F.P�o . ., <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes_ No_ Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: .*/.✓f <br /> 4 . FLY MOSQUITQ OR VECTOR POTENTIAL <br /> State passible vector potential. & necessary control: �✓�f <br /> 5 . TOILET/BATH AG TTFS <br /> No . & location existing : ,¢ Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION <br /> RA T N HISTORY _ 1 <br /> _0101'DESJf.Ga PFd �Ei✓E�9L 1A�OdJr{/4� !�✓c�� /r2 A�.C�L%li7 SCS <br /> 7 . GENERAL SANITATI N <br /> State any problems not previously noted: <br /> 8 . POPULATION DENSITY <br /> Appx. No . People per sq . mi . v/���`d�id.��� R°F!/DFd9� <br />