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(2) <br /> 1. SEWAGE - <br /> Distance to Public Sewers �� -Connection necessary: Yes _ No•'_ <br /> Does existing septic system comply with Ord. #549: Yes _ No _ Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> kdjd t ion or comments: <br /> ` . . _ .... . <br /> 2. WATER SUPPLY _. <br /> Is water supplied by private well: Yes _ No ------Is well proper: Yes _ No <br /> State deficiency: <br /> Does existing or proposed use make this well public water: Yes _ No G.-- <br /> Sample of well water taken: Yes _ No Date Taken Results <br /> Additional information or comments: Za <br /> 3. GARBAGE & REFUSE A 0✓J- cW S :►-j Oa rc.e�� .�t 2 <br /> Licensed scavenger pick-up: Yes _ No Service Area No. --- <br /> Other proposed disposal method: <br /> Fotential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. AIR PO LLU TION PO TEN TIAL <br /> State possible burning or processing pollutants & necessary control: --� <br /> 6. TOILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY . <br /> o. GENERAL SANITATION <br /> State any problems not previously noted: <br /> 9. FOPULATION DENSITY -- ---- <br /> Appx. No. People per sq. mi. <br />