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(2) <br /> 1. SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes _ No <br /> Does existing septic system comply with Ord. #549: Yes — No Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> Additional information information or comments: Lar is uoz �-taRCG IzLjoucl-u T-c, Irysrra-L.L. <br /> f2E&�0i ?9jo sE-C- ►6 SqS7iFH ef TSR chP(�N X1.0 VU <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes —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: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes /No Service Area No. S-T�K cAu• <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 POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: <br /> A <br /> 6. TOILET/BATH FACILITIES <br /> 7 <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> S. GE14ERAL SANITATION <br /> State any problems not previously noted: <br /> Al <br /> 9. POPULATION DENSITY <br /> Appx. No. People per sq. mi. S� S1 pl�1lS1JAL_� <br />