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i. Dike to Public Sewers Connection necessary: Yes No`-- <br /> Does existing septic system comply With Ord. 0549 : Yes No— <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WAJER SURE <br /> Is water/supplied by private Well: Ye�� No Is well proper: <br /> Yes_j,,,No State deficiency: <br /> Does eK.i-ting or porposed use make this well public crater: Yes <br /> No ✓ Sample of wall water taken: Yes No � Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE <br /> Licensed scavenger pick- Yes No Service Area No. <br /> Other proposed dispos method: <br /> Potential problem: <br /> 4. Er,X. MOSQUITO OR Y Z^ n )' <br /> State poesible vector potentiAl & cessary control: <br /> 5. IQILETZB61HF�LUJTES <br /> No. & location existing: Additional <br /> facilities needed_._.-�____ <br /> 6. E ort c: HISTORY <br /> 7 . GENERAL SANITATION <br /> ION <br /> State any problems not previously noted: � <br /> 3 . POPULATIOtL DE ^STTT_v <br /> Appx. No. People per sq. mi. <br />