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Septic Site Plan <br /> 555-24-004251-PRMT <br /> KING,ANNA A RESIDENTIAL D EVELOPM ENT RECE VE D <br /> 115 MAPLE ST, GATES ttff�� . <br /> 093E26CB00700; 0.24 acres t 7 O D Total Acres i Z V JUN 03 2024 <br /> Block Lot <br /> Drawn to Scale: Not Drawn to Scale -OR- 1 square= feet <br /> . STATE CERTIFIED , . . . . . . _ . . .. r-, . . . . <br /> Waste Water Specialist <br /> � EH-W90147892• <br /> - <br /> Kimberlee A.Aldrich <br /> • <br /> I oast <br /> . .r.A.k . fie. be. <br /> . . rc impvcot rep1,44 •• <br /> 6% <br /> 1 4' 2 <br /> . . . . . . . <br /> . .R . . .' . . . I� . <br /> r � � <br /> 1 1. . . s- '. . . . . . . . . . . . . <br /> I certify that the above information is accurate to the best of my knowledge.I AM nib[ ]Owner or NAuthorized Agent. <br /> NAME(please print): / l r Yel",' k(•% Tom. Exc. Telephone# ,?)3'' 3 2. 0 Y$Y <br /> Applicant's Signature: Date: ' S-Z 9-Z Y <br /> Applicant's Mailing Address: 2 Y C I' St <br /> City: J 4. le✓uk Zip: [ 73 I ' Applicant's email: •L b- 0 A a 1. c o+M <br /> S-31-1-2017 <br />