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Distance to Public Sewers Connection necessary : Yea No-- <br /> Does <br /> o_Does existing septic system comply with Ord . 0549 : Yes No— <br /> Unknown If no , explain : <br /> Describe septic installation to be installed : <br /> 2 . ITER SUPPI, <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use mare 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 <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method : <br /> Potential problem: <br /> 4 . FLY; MCiS�►UITO Ofi _Y i` AT, <br /> State passible vector potential & necessary control: <br /> 5 . TQGLETISATH EACIL TEa <br /> No. & location existing : __ Additional <br /> facilities needed _ <br /> 6 . FREVIOU2 OPERATION HIST.CUX, <br /> 7 . GENERAL SANITATION <br /> State any problems not previously noted: ._._ <br /> 8 . PC}PULATISTTY <br /> Appx. No . People per sq. mi . <br />