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set. no. 3-76-58 <br /> APPLICATZON TO <br /> DEPARTMENT OF ~NVIRONM~NTAL ~UALITY <br /> FOR <br />STATEMENT OF FEASIBILITY .FOR PROPOSED SUBSURFACE S~AG~ DISPOS~ <br /> <br />x~ec. ~1723 <br /> <br />RETURN TO: <br />Marion County Health Department <br />Salemm Oregon 97301 <br />Phone: 588-5346 <br /> <br />FEE ~CHEDULE~ <br />Non-refundable $25°00 <br />per 10t to be submitted <br />with application° <br /> <br /> DE___SC.~RIPTION== OF PARCEL (Attach Plot Plan as Exhibit A) , <br /> <br /> ShOW location O~ ~oposed S~Sur~a~ Sewag~ ~ystem or system~ on ~he plo~ plan <br /> which ~s a%%ached es Exhibit A. <br />. NOT~: The M~ion County ~alth ~p~ent, as con~act agen% for the D.~.Q., must <br /> comple%e a aite investipatton ~fore a s%a%~ent can be 'piven. In order ~ verify <br /> soil t~es and de%ermine this suitabilityt i% is often necess~y to require two (2) <br /> soil te~% ~].es 2 ft. by 3 'ft. wide and 4 St. deep and 75 f%. ap~t in the <br /> proposed for the sewage system. You will be contacted if field Xnves~gahion <br /> lndicahes a need for such ~les. Tesh ~les ~e required for ~re t~ one p~cel. <br /> ~s repor%~ when completed~ will ~ elimina~ the need for req~red planning <br /> co~ission approval, building or location permits. <br /> Te~% hole~ ( ) have ~en prepped ( ) will be ~ep~ed ~7l~ ~ ~ <br /> ~ } (date) ..... <br /> <br /> I HEREBY R~ST FROM T~ DEP~NT OF ENV!RON~NT~ QU~ A STATE~NT OF <br /> OF TH~ ~VE ~THOD OP SEWAGE DISPO~ ~R ~E ~VE DESCRIBED <br /> please prtn% <br /> <br /> ~.~gnat~ of Applicant <br /> ~dress of Applicant ~ %~o ~' .3~ d ~ Title <br /> Ci~y~ S~ate~ Zip Code~q~~, ~ Date ~ <br /> (for ~ or ~ent use only) <br /> <br /> Co~en~s and rec~enda%ion~ based on S~s~face Site Investigation by D~ or Contract <br /> Agent: <br /> <br />The soils are similar to Woodburn silt loam. Silty clay loam at 24". Mottling was <br />observed at 30" to 36" with a restrictive layer greater than 36". Recommend approval <br />as requested with the sewage system to be located on the south end of the property. <br /> <br />Agent Marion County Signature Date 5-17-76 <br /> <br /> Statement of D~ Relative to ~ve ~plica~ion <br />(X~ ~e a~ve described meted of sewage ~s~sal i~ ~proved subject to the <br /> following condi~ons ~ <br /> <br />( ) T~ a~ve described me~d of ~ewage dis~sal is not approved for t~ following <br /> <br />.... r' ..... R.S;' May 28, 1976 <br /> Assistant iFa~ffagerc. Ssa. l[ ]North Coast Region, DEQ <br /> · ERMAN, R.S., Director <br /> ENVIHONMENTAL HEALTH SERV]CES <br /> ~-~rJon County Depar~n~ <br /> B~m 220, 3180 Center Str~ef, <br /> <br /> <br />