Laserfiche WebLink
,ti° "-7 <br /> Distance to Public Sewers <br />` Does existing septic system comply with 54rY: Yes <br /> No <br /> Unknown If no, explain: 8 : Yeses, No_ <br /> Describe septic installation to *be installed: <br /> 2. WATER Suppnz / <br /> Is water supplied. by pri,rata well : Yes V ��a . <br /> Yes No State deficiency: Is well proper: <br /> e , �, S <br /> Does <br /> No i <br /> sting or porposed use make this well public water: Yes_ <br /> Sample of well water taken: Yes No— Date taken—. <br /> Result$. � Additional information or comments <br /> 3 . <br />'t Licenced scavengerick- : v t/ <br /> Other p uNo �r <br /> Proposed disposal method: <br /> yes hod: Service Arezi No. <br /> Potential problem: <br /> 4. S i^Tf} Rtj' F TT <br /> State possible vector potential � <br /> x necessary control:_ _ <br /> Nva • <br /> No . & location exi;t4 g: <br /> facilities needed Additional <br /> 6. nR �; '" r -Tnpv <br /> 7 . ^r 1RAr' 1T-; TATTnN <br /> State any problems not PrBliou 17 noted: <br /> n <br />