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12332353
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Last modified
8/23/2024 8:33:59 AM
Creation date
8/21/2024 4:26:29 PM
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Permits
Permit Address
6753 SHAW HWY SE
Permit City
Aumsville
Permit Number
555-22-010037-PRMT
Parcel Number
082W24 01100
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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a0l(D03 <br /> SITE PLAN FOR PROPOSED RESIDENTIAL// DEVELOPMENT [1J) ,C I,I]V <br /> Site Address: SA t i /A / S S . 4 sv!'k /Je9 .3 J <br /> Township Range Section Tax Lot Total Acres �tl0�� 2022 <br /> Subdivision Block Lot MAARION COUNTY <br /> ❑ Drawn to Scale: } Not Drawn to Scale -OR- 1 square= feet <br /> BUILDING INSPECTION <br /> . • A. . * . k_ ,k . X-:--- . ...- . . ---.. --. A, h.1- . . <br /> . . ekv M s' <br /> Tc <br /> " 1 „ ' . . lam) . ,- 'lc. <br /> l'1143 91 i/f.,PPROVED FOR SEPTIC. . , <br /> •1�' y t/'5„ /,, INSTALLATION ONLY" �O - STATE CERTIFIED .° - <br /> . . . Environmental Heplth Speotalitt ,%se <br /> it is the responsibility of the -� EH-S-102 6540 <br /> - . applicant to coordinate th <br /> rr � <br /> S . ' ' I e rerinents with ................................ . �;; 7- - <br /> Robert Gooc wi <br /> . G. .i! .3�aa--' '. <br /> o ,5 <br /> • <br /> 4 :2?) • <br /> �dyY7.� <br /> . 0 • - - • <br /> C3 f`ofIj 7aL/' Zy 3 <br /> . . ... . . . . .__ . . . . . . . . . . . . . . . . . _ . . . . li <br /> S <br /> V) <br /> I certify that the above information is accurate to the best of my know��ledge.'I AM THE[ ]Owner or[ ]Authorized Agent. <br /> ' <br /> NAME(please print): Herbert C. Wiison/LJ , .,i GtJr nnTelephone 4 503 - 873 - 7157 <br /> Applicant's Signature: _....______re._ <br /> 4 ` Date: `/ -,;() nn <br /> Applicant's Mailing Address: 8778 Cascade Hwy. NE <br /> City: Silverton Zip: 97381 Applicant's email: Ionepineseptics8778@gmail.com <br /> S-31-1-2017 <br />
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