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r-w e rLg1Y <br /> (Draw To Scale) <br /> SCALE __" TO <br /> 1. Names of streets or roads nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. <br /> 3. Dimensioned outlines and locations of all existing and proposed structures, including covered areas such as patios, <br /> driveways and walks. <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed-sewage disposal'.system, <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <br /> 5.`Location-6f other wells within radius of 75 feet on the property or adjoining property. <br /> & Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> { R� <br /> 3 -K <br /> f <br /> � E <br /> P <br /> 1 <br /> l <br /> # y �J, <br /> 1 <br />