Laserfiche WebLink
1 . SEWAGE <br /> Distance to Public Sewers 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: <br /> Z . NATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency : <br /> Does existing or porposed use make this well public water: Yes- <br /> No­ <br /> esNo _, Sample of well water taken- Yes No Date taken <br /> Results Additional information or comments <br /> 3 . ZSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method:. <br /> Potential problem:__ <br /> 4 . FLY. MOSOUITg OR YE TnR PQ'[j,:UT7 L <br /> State possible vector potentiftl & necessary control: <br /> 5 . 'Lar ,FT/PATHFACILITES <br /> No. & location existing : Additional <br /> facilities needed---. <br /> 6. PRFy nf7S f PFRATIO.' HI TnEt <br /> 7 . GENE S 11TA'rTnj, <br /> State any problems not prey*iouo ly noted:- <br /> 7=T <br /> oted:_ <br /> L1r�xjTTV <br /> Appx. No . PeoD le per coq Li i - --- <br />