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SEWAGF <br /> Distance to Public Sewers 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 installed: <br /> 2 . WATER SUEPLY <br /> Is WEit supplied by private well : Yes coo Is well proper: <br /> Yes�o State deficiency : <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 <br /> 3 . GARBAGE & REFUSE �� ray, %�.o �r/C"�d•� <br /> Licensed scavenger pick-up: Yes -No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem : <br /> 4 . FLY. MOSQUITQ OR V E^.TO) ZCi'j'rNTIAI, <br /> State possible vector potentiitl & necessary control : <br /> 5 . TQILET/BATH FACILI U <br /> No . & location existing : — Additional <br /> facilities needed _ <br /> 6 . PREVIOUS QPERATT9N H ;T= <br /> 7 . UN +.RA , SAIJ11A]'ION <br /> State any problems not previously noted : - <br /> 3 . <br /> oted : _3 . OPLATIONDr, STIR <br /> Appx. No . People per oq . mi . <br />