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.Ik <br /> Distance to Public Sewers Connection necessary : Yes No <br /> r Does existing septic system comply with Ord. 0549 : Yes No_ <br /> „ Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATFR Sppnr,7 <br /> Is water supplied by private ;cell : Yes No Is well proper: <br /> Yes No State deficiency: <br /> Does existing or pornosed 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 & RFFRSF <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLY, MnSOUTTn QR 7TCTnR PnTZNTTA r, <br /> State possible vector potential & necessary control: <br /> 5 . Te)TT,�,7/BATH r'A(' i ZT S <br /> No . ez location existing: Additional <br /> Facilities needed <br /> 6 . ?RFyTnrS nPFBATTot; H77, Tng:v <br /> 7 . <br /> State any i roolems nc t pre . !ous' ;T noted : <br />