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I , 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 /> Desgri a septyic installation to 'be installed: <br /> /E� lc <br /> 2. WATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yeses No State deficiency : � �f � <br /> Does existing or porposed use make this well public water: Yes <br /> No--Z, _ Semple of well water tarsen: 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 . ZLLY-L MOSQUITO QR VB;,7T zCi'rLE T_AL <br /> State possible vector potentiftl FA necessary control: - <br /> 5 . ZQ_TLET/BATH PACT ,T'I'ES <br /> No. & location existing: % — Additional <br /> facilities needed _ <br /> 6 . PREVIOUS OPER_ATIO - HH � , <br /> 7 . GENERAL SA1Uj&'(' _Q <br /> State any problemz next previously noted: <br /> 8 . FQPILATIOtd Dr iY <br /> Appx. No . People per rq <br />