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PLOT PLAN <br /> (Draw To Scale)TO <br /> . <br /> -1: Names o streets or roads nearest tg_or bounding the roperty. <br /> 2. � g <br /> mlensi edoutline an I�7ation� o allexis ti andr edstr ayine c the p , �.p p ucrincludg cover�e4at�assuch as patios, <br /> driveway andw �C� �. � <br /> pu G 9 p _ . <br /> -4-.--Location f ho se a er utlet, ublic sewer, 3ewa a dis osal syster-te a*,posed-sew a disposal system, <br /> propose expansion of sewage disposal system, or any other possible sou�E�`ofEOntamination. <br /> - . 5. Location f other wells withinradius of 150 feet on the property or adjoining I . <br /> 6. Location f sewage disposal system on adjoining property or within a radius of W0 f66t. <br /> -�-, <br /> I <br /> -4 <br /> L7 <br /> I <br /> 4 — 1 <br /> .20P 11 11 <br /> © <br /> I <br /> I - - <br /> I <br /> i <br /> i <br />