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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: 2‘a &1 jj )C \.L P.--- - 1 y0%,•-s <br /> Township Range Section Tax Lot Total Acres EXPIRE D <br /> Subdivision Block Lot <br /> ❑ Drawn to Scale: •❑ Not Drawn to Scale -OR- 1 square= feet <br /> r &i <br /> 1/1 <br /> ('r4.5 <br /> NOG+6 le y4Ls •. n t: 5.o^. �v�,,� . <br /> {—o rc�c�a -(�,�I.ti- k��-F�.� •. o <br /> rc�v►� f�S C�►' ov�w Ti.:�fitl� o <br /> • i P k2o ' c s-.l r q,In f/� . e . ()! i✓tom <br /> • E14C".P cGl . 4F/k°''' . Res ). . . . . . . . . . . .(i . (' y-AS .In'^, <br /> ov:,' ( /24.46.,,24-, <br /> (✓of Cc.k cti,- <br /> . . . . . . . . . . . . . . . . <br /> "APPROVED FOR SEPTIC <br /> STATE CERTIFIED f INSTALLATION ONLY" <br /> . EvironmentaI Health Specialist . . . . . . . . . It is the responsibility of the <br /> -;. . EH.S-10206540 . . . _ . . . . .. . . . . . . . . . applicant coordinate.these <br /> •• requirements with all others. <br /> . . :; . �✓. <br /> Robert Goodwin <br /> I certify that the above information is accurate to the best of my knowledge.I AM THE[ ]Owner or 1 1 Authorized Agent. <br /> NAME(please print): Herbert C. Wilson Telephone# 503 - 873 - 7157 <br /> Applicant's Signature:) C. LU 1,,5 0 Date:f' 6 "al. <br /> Applicant's Mailing Address: 8778 Cascade Hwy. NE <br /> city: Silverton Zip: 97381 Applicant's email: lonepineseptics8778@gmail.com <br /> S-31-1-2017 <br />