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1 . SEWAGE <br /> Distance to Public Sewers 1� Connection necessary: Yes No. <br /> Does existing septic system comply with Ord. #549 : Yes L No_ <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed:���� <br /> 2 . WATER SUPPLY <br /> Is Water supplied by private well : Yes Y No Is well proper: <br /> Yes_. No State def ici:,ncy : <br /> Does existing or porposed use make this well public Water: YesX_ <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comment/ <br /> /�,O.(��E���:✓6 e69 e�r�`./��/TE/i1 a t.�//l/4���/ e�9!„/J� �✓e.`�.',/ ��/F2�i�''fe�t�e;� <br /> S . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes X No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLY. MQSQU_TTO OR VECTOR E )TTN1 TIAL <br /> State possible vector potentif►1 P.c necessary control: <br /> 5 . TOILET/BATH FACIL TTES <br /> No. ec locution existing: Additional <br /> facilities needed <br /> 6. PREVTona CPC/RATTON HTSTnpy <br /> 7. GENERAL SAITTIATTON <br /> State any problems not previously noted: <br /> S . POP)LATIntl DrENSTTY <br /> Appx. No . People per req. mi ,!��/�r�:!��,.A�— �CJf✓�aF��-s .G� <br />