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r <br /> i . <br /> Dice to Public Sewers IV 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. WATER SUPPLY <br /> Is water supplied by private well : Yes X 'Jo Is well proper: <br /> Yes No 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 <br /> Licensed scavenger pick-up: Yes ' No Service Area No. <br /> Other proposed disposal method: - <br /> Potential problem: <br /> 4 . Y. MOZTTcZ OR Vr. T-M-M)rJ1 aTI <br /> State possible vector potentiftl & necessary control: <br /> 5 . TOILET/BATH FAC�ES <br /> No. ek location existing: Additional <br /> facilities needed - <br /> 6. PREVTORS OR tiRA TON HISTORY <br /> 7 . GENERAL SANITATION <br /> State any problems not previouoly noted: <br /> 3 . POPULA110tj D .ySTI <br /> Appx. No . People per eq. mi . <br />