Laserfiche WebLink
1. SFS <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord. #549 : Yes No_, <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WATER SUPPLY <br /> Is water supplied by private well: Yes No Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porposed 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 /> '" 10 <br /> 3 . G� j -r.e-"r <br /> Licensed scavenger pick-up: Yes_ No— Service Area No. <br /> Other proposed disposal metho <br /> Potential problem: <br /> 4. FLY. MOSOUTTO OR V F^.TOPC/=INTTAL <br /> State possibly: vector potential & necessary control: <br /> 5 . TOT , ET/BATH CACILTIES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6 . PREVTOna O ERAT OU HISTORY <br /> 7 . GENERAL SAITTIATTON <br /> State any problems not previously noted: <br /> S . PQPULATTOIJ DENSTly <br /> Appx. No. People per sq. mi . <br />