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1 . A/ <br /> SEWAGE A,/ Z N <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 /> ;< 1 <br /> 2 . WATER SUPPI,`t <br /> Is water supplied by private Weil : Yes Is wellro er: <br /> P P <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 : x ,� <br /> Potential problem: <br /> 4 . FAL MOSQUITO OE Yl�iS1L�PC)=1 LIQ <br /> State possible vector potentifFtl & necessary cor:ttrol : <br /> 5 . TQILET/BATH FAt;I iE� <br /> No . & location existing : Additional <br /> facilities needed <br /> 6 . PREVIOUS OPERATION laT��RY <br /> ZV L e r J <br /> 7 . GENERAL SANITA'1'Is71 <br /> State any problems not previou.sly rioted- - -- <br /> 8 . <br /> oted: ._ _8 . FSPCTLATIQ14 DE :I -1 r <br /> Appx. No . People per sq. <br />