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SEWAGE <br /> Distance to Public Sewers Connection necessary: Yeses No_ <br /> Does existing septic system comply with Ord . #549 : Yes x No_ <br /> Unknown If no, explain! <br /> Z -{O 12.x✓ qe 44/PL GLCLt �G�y�Q <br /> Describe septic installation to be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes _ No- Is well proper: <br /> Yes_ No_ State deficiency: <br /> 51k &sef Co-O <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 <br /> Licensed scavenger pick-up: Yes_ No_ Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY. MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control : <br /> 5 . TOILET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION HISTORY <br /> 7 . GENERAL SANITATION <br /> State any problems not previously noted : <br /> 8 . POPULATION DENSITY <br /> Appx. No . People per sq. mi . <br />