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(Draw To Scale) <br />SCALE " TO <br />Names of streets or roads nearest to or bounding the property. <br />Outline of the property, giving dimensions and North direction. <br />Dimensioned outlines and locations of all existing and proposed structures, including covered areas such as patios, <br />driveways and walks. <br />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 />Location of 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 />il\ 40 <br />t , <br />_ . <br />r_ <br />_ _ i P a , f 0 I <br />I, <br />I <br />, 1111 <br />In <br />III. <br />II I <br /> <br />, <br />-7- <br />4_ <br />( <br />1 <br />1 1