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(2) <br /> 1. SEWAGE <br /> Distance to Public Sewers Mjtj_-'5 Connection necessary: Yes _ No , <br /> Does existing septic system comply with Ord. #549: Yes _ No _ Unknown _,E,- <br /> If no, explain: <br /> Describe septic installation to be installed: LJtlLrb4 <br /> Additional information or comments: rrti aL. <br /> 1;/Wtf 1404Ll✓� <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes Y No _ Is well proper: Yes No _ <br /> State deficiency: <br /> Does existing or proposed use make this well public water: Yes _ No <br /> Sample of well water taken: Yes _ No � Date Taken Results <br /> Additional information or comments: exi 5Vfui- plu (Inp-ca- P.- 1'baLA 'Vo wee <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, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. AIR PO LLU TIOI1 PO TEI1 TIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. TOILET/BATH FACILITIES y� <br /> No. & location existing: �/�/i Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> 8. GENERAL SANITATION <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. j� (, 7s <br />