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I <br /> ..:_ , <br /> ,o®068133-STg <br /> N SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> 2020 <br /> DEC�p 9 <br /> IECEVED <br /> Site Address: 5t166 '4Lt.t�GG Wfsl Sc <br /> ' ���COUNTY0�2- /c(' mo 4000 Total Acres ����I��� � U�IS8FC "ION <br /> TAXLOT <br /> ❑ Drawn to Scale: •❑ Not Drawn to Scale -OR- 1 square= feet 11 a ( IP(/to <br /> .-1,,,A <br /> .1 . . . . <br /> CI. .SM V� 1.60". <br /> 71 <br /> . . . . . . i.!e.pA 1,� 6 .5t ?rl�7 S. <br /> ... <br /> t ci .., .. <br /> ... . .t,.. . . . . . . . . . . . . . <br /> . . . . . .4 CAn. -6. '1 • ii-,' ' • 6. ti A <br /> . r p ,, ,,,,,b \ k) N . . <br /> • " . . . . <br /> . . . . . . <br /> " . . . . . <br /> . ; 11-\.i.1. - . . I i.'il(..... - . . t <br /> . I 7cY/AL.P44/n!r/CCD. � 1A-Pf liew �9 <br /> ESZi ! . , Tom` j" i. i, .<:. . . . ,.j, . vsisv,.... ,. .. : i G, . .‘ .. ...f.: -. oe. : . <br /> m• �� . . <br /> s <br /> • <br /> I certify that the above information is acew'ate to the best of my knowledge.1 AM THE( ]Owner or IA Authorized Agent. n / ` <br /> NAME(please print): .c,517,/, �,n.� t Telephone# 0e — L:11:: <br /> C_. ` 2�}�O/ j K,--- 4' y], ; <br /> � � ! vv <br /> Applicant's Signature: ,,r.--y 1' �,/ )ate: a'^ 7- O <br /> Td I1N <br /> Applicant's Mailing Addres7 J(. 7 d�A / /moi k/A t" ,c,7.-- <br /> , <br /> c,7.Y � � <br /> City: ,S tst./•i, Zip: q1/91. / Applicant's email: r...1/0=.1� �`� L_ Y $t rP _ Y S;},{.;; .4u;m CU✓►A€1(1 ` GJ <br /> t' c <br /> S31-6-2020 G:1Forms\SepticWORMSIS-31a SepticSystemSitePlanRequireinents for SITE_EVALS_2020-07-2 .doc <br /> (I IT'., <br /> .. <br />