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A~PLICATION TO <br /> ,, .....DF/:~ART'MEN_~T O,F ./~NVIRONM~NTAL QU~I~ <br /> FOR <br /> STAT~NT OF FE~I~I~ .FOR PRO~ 5~S~AC~ S~AGE DISPOS~~ ' <br /> <br />Marion Co~ty ~lth ~ ~ ~d ~, o~ ~ ', ~n ~efu~le $25.00 : <br /> <br />which ts attached as Ex. bit A. <br />NOT~: T~ M~ion Cowry ~alth ~p~ent~ as con.act agent for the D.E.Q. ~ must <br />complete a site investigation ~fore a stat~ent can ~ 'given. In order ~ verify <br />soil t~es ~d dete~lne ~s suit~ility~ it Is often n~ess~y to require t~ (~) <br />soil test ~les 2 ft. by 3 ft. wide and 4 ft. deep and 75 ft. ap~t In ~e ~ea <br />proposed for the sewage,sy~ ~u will ~ contacted tf field lnves~a~on <br />indicates a need ~r SUC~' ~les, ' '~st ~les ~e =e~ired for more than one <br />~ re~rt~ w~n c~ple~d, will ~t el~inate ~e need for req~red pla~lng <br />co~fssion ~p~Val, ~lldi~ or loca~on pe~its. <br /> ~st ~les ( ) have ~en prepped ( ) will ~ ~ep~ed by ==- (dat~) ~-- <br /> <br /> ~ ~E ~E ~D OF S~AGE DISPO$~ ~R ~ ~ D~RIBED <br /> please prin~ ,. <br /> Nme of Appllc~ ~ ~ ~uSChc~ ',, "'~i'~hSt~e"'of <br /> Address of Appltc~t 6~0~ :.~ ~. Title <br /> City, State, ~p ~de ~ ~.~ . ~ ~Tql ~ <br /> <br /> (for ~ or Agent use only) <br /> <br /> Agent: <br /> <br />~e soll~ ~e ~ll~ ~ fialk~ silty clay lo~. S~ong s~uct~ed silty clay at 24". <br />Approved for one ~mesite on 10 a~es pending accept~le plot plus prior <br />s~c~on. ~e sewage syst~ is to ~ located at least 150' ba~ fr~ <br />~ shallow soil dep~ at ~ f~nt of ~e proart. <br /> <br />Agent Ma~io n County Siena truce -~' ~te 5-17-76 <br /> <br /> Stat~ent of D~ Rela~ve ~ ~e ~plication <br />( ~ ~e a~ve descried me~ of sewage ~sal ls ~pro~ed sub~e¢~ ~ ~ <br /> <br />The above described method of sewage disposal ia not approved for %he following <br /> <br /> ! ' '~.~, .,z_w .~: ~- ' <br /> <br /> ' 3 ~.7~ <br />Director <br /> <br /> <br />