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DCQ SITE PLAN FOR PROPOSED SEPTIC <br /> Site Plan Must Be Current - <br /> ' Site Address:: IS() , 1-1 y."-i r&tS. 1•ri •IV e city: 6 `4 Cr"1r o r••• ' <br /> Tax lot#: 0.1 W 1.22.. Acres:. (Pe a C;11 - Subdtvislon: • <br /> Lot Bio¢k:' Propeity Owner. 1C4k.t' C Alit'h <br /> • 1 <br /> . Scale: 1 Square= '-C' Feet SITE PLAN MUST-SHOW ALL.PROPERTY LINES AND DIMENSIONS ' <br /> E. le. . . . <br /> . . . . . . .. . . . . . . . . • <br /> • ,<a'° �. 3`5..�. . . . . of .. . . . <br /> • <br /> •.• vi 7',• • 0 • • • • • • . . <br /> . t� . . . STATE CERTIFIED / <br /> . Environmental Health Specialist F <br /> s'� <br /> E11$-10227575 t <br /> . .4..')'3';'.9 : ' : . —p: Aidan Flamm es <br /> . . . .. VC• . Boa - • <br /> • .. . 0.,..... .. . . .. . . 4,.., . --. .-., ' --:',.• -. -.7--. • . . .: . . . . . • . • <br /> . • • ... in 3 6(-4 k_._._........glr---eP tri _44- <br /> . c^fy d. . . . /. . . ... . . . ._C3 'Jo rlipi .- �. • x�a . <br /> I certify that the above information.Is-accurate to the best of my knowledge..This..site plan Is based on actual . <br /> measurements and,conditlons on the site. . <br /> I am the []Ow r or E Authorized Agent. Name(please print): 0.1 C. .144,J.fa,„. t=XC. <br /> Signature: f Date: ►0/37Z3: • <br /> 6 <br />