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i . $EWAGFL <br /> Distance to Public Seders Ned' 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: F1�N�ST��vG- <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yesk: No Is well proper: <br /> Yes ✓ No State deficiency: <br /> Does isting 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. MOSOUTTO OR VROTOR P0TENTIAL <br /> State possible vector potentiftl 8A necessary control: �jO CHUoc <br /> 5 . TOTLET/BATH FACILITES, <br /> No. & location existing: 1 lk 140c� 5 Additional <br /> facilities needed - <br /> 6. PREVIMS OPERATION HTSTnRY <br /> S <br /> 7 . GENERAL SAUj `19 L0.N, <br /> State any problems not previously noted: <br /> S . POPUL.ATION DENSITY <br /> Apex. No. People per sq. mi. <br />