Laserfiche WebLink
r�-�zQ.-eek <br /> 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 /> 2 . WATER SUE <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No State deficiency.- <br /> Does <br /> eficiency:Does existing or purposed 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 . $jj_L MOSQUITO OR V ZQJ C PS)' .,NTIAL — <br /> State possible vector potential & necessary control : <br /> 5 . TQTLET/BATH FACILI7T <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. PREVIOUa_OPERATION HISTORY 11 <br /> j "d ` s <br /> 7 . GENERAL SANI'LUJON <br /> State any problems not previously noted: -- <br /> 8 . POPULATION DENSITY <br /> Appx. No . People per sq. mi . <br />