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SCALE --_ - TO_--- t <br /> 1 Names Ot.51rBCls or toads nearest 1C O. - undrng the t•roperly <br /> 2 Oulltne of the property, giving dimensions and North direction <br /> 3 Drmensiongd outilnesand locations of ail existing and propc.sed structures.rnciuC ;c oterr d.„r•a°s; . 't n5 p+1 S. <br /> driveways ,alks. <br /> 4. location o. use sewer outlet, pub;c sewer, sewage system Cr proposed srti+ +nc .: .,c.:a' system <br /> proposed gxpanston of sewage ritsposat system, or any ott•,er possible source 0 contamtnatu:n <br /> 5 location of other wells within radius of 150 feet on ;tie propp"ty c, ac!loiring property <br /> 6. Location bI sewag^disposal system on adjoining propert, or t.:lhin a radius of 150 'ret <br /> E } <br /> I ! ` <br /> I <br /> ;^ _� -..—'-- - -- --• - --- -� -- - ----• - - - - - • - ._._.�: jai <br /> 1 -.— -- _- -- - - — , <br /> -=�� <br /> j I n r I- t i <br /> L—L <br />