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Imo IC. 0 r <br /> ill/ <br /> DEC 1.3 2022 <br /> SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT _ <br /> MAi'li r•r'CJOU TY <br /> Site Address: U 4%3 4.,M.r r t Or LvO.ts Ole-- ;UIL D -n INSPECTION <br /> Total Acres `\ <br /> ❑Drawn to Scale: •ci Not Drawn to Scala -OR- I square= feet <br /> t. <br /> *'47 <br /> • <br /> • <br /> • <br /> o �^ . • <br /> • • - - 1.51,1•44). • • • I <br /> } <br /> I testify that the above Inforatatioa Is accurate to the best el ray lmowtedge.l AMTHE I I Owneror((Authatized Agent <br /> NAME(please pciat): tC0 t% � Teiephonei 9-)3--S�'+QQ— tO1Z <br /> Applicant's Sagest= Ikitc <br /> Applicant's Mailing ��'0. <br /> ��� 6 x t Applicant's mail: r.JLI.xt.l0� <br /> I�taa+-�r�--�'P-L�;. APP ! �tn U144ck .C-431J"\, <br /> S41.62020 G.iFamuLSeptieFORMS1s-3"lasepticSystcmSitcPlanRegairono s forStfS EVAl.S_2020.07-20.dcc <br /> APPROV STATE CERTIFIED <br /> F.,.),..... <br /> a _ 4 Environmental Health Specialist <br /> It is the res -�TIo -� ,-\pa f., EH-S-10206540 <br /> ponsibilit Cc <br /> epAlicarat to 000rc ir��te se ,� �� � " ram. <br /> requirements with . . the�� <br /> ail Other;; Robert Goodwin <br /> iP- Ea <br />