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(Draw To Scale) �. .,� „" . .4, <br /> 1. :Nam of streets or roads nearest"to or bounding the,property. <br /> 2. Outline of the property', giving dImensions'and-=North direction. T <br /> 3. Dimensioned outlines and locations of all existing and proposed structures,including covered areas such as patios, <br /> driveways and walks. ` I <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage disposal system, H <br /> ?,proposed expansion of sewage disposal system, or any other possible source o'Pcoytamination �� snt <br /> 5.` Location of'other wells within radius of 75 feet on the property or adjoining'pro'property. }' <br /> 6. Location of sewage disposal system on adjoining property or within'a radius of X50 feet <br /> Ott . „ 4_: <br /> A' <br /> , T <br /> N <br /> A ' <br /> 1� i >✓ T / 1 '1 ' <br /> _ 3 <br />