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DEPARTMENT OF ENV/.RONMENT2J~ QUALITY <br /> FOR <br /> STATE~BN9 OF FEASIBILITY FOR PROPOSED SUBSQRFACE SEWAGE DISPOSAL <br />RETURN TO: FEE SCHEDUL~:~ <br />Marion County Health Department Non-refundable <br />Sa!emt Oregon 97301 per lot to be submitted <br />Phone: 588-5346 with application. <br /> <br />DESCRipTION OF,. P. ARCEL (Attach Plot Plan as Exhibit A) . <br /> Section~-_~_~; TownshipS; Range ! ~2; County of M~lon, .Oregon, Tax lot <br /> Narrative ~scription: '~6~ ~&~=O0O- ~OqGF- <br /> <br />Show locatlon~f proposed ~su~sewage system or sys~s om'"t~~ <br />which is attached as Exhibit A. <br />NOTE: The M~ion County ~alth Dep~ent~ as con~act agent for the D.E.Q., must <br />complete a site investigation ~fore a star.ant can be 'given. In order ~ verify <br />soil t~es and determine this sutt~ility, i% is often necess~y %o requt=e two (2) <br />soil test ~les 2 ft. by 3 'ft. wide and 4 ft. deep and 75 ft. ap~t in the <br />proposed for the sewage sys~m. You will be contacted if field inves~gation <br />indicates a need for such ~les. Test holes ~e required for ~re than one p~cel. <br />T~s report~ w~n completed, will mot eliminate ~e need for req~red planning <br />co~ission approval~ building or location permits. <br /> Test ~les ( ) have been prepped ( ) will be prepped by <br /> --~ (date) ---- <br /> <br /> I HEREBY R~QUEST FROM THE D"DPARTM. ENT OF ENVIRON~N'ZAL QUALITY A STATEMENT OF <br /> OF THE ~OVE ~THOD OF SEWAGE DISPOS~ ~R ~E A~VE DSSCRIB~D P~CBL. <br /> please prin~ <br /> N~e of Applican% ~m~ /~u~ Signa%~e of Appltc~t~ <br /> Address of Applic~t ~~ Title ~~/ <br /> City, State, Zip Code ~ Date _~~ . <br /> <br /> (for D~ or Agent use only) <br /> <br /> ~ents and reco~endations ,.based on Substrata Site ~nvestigation by D~ or Contract <br /> <br />The soil~ ~e s~il~ to Salk~ silty clay lo~. S~ong ~uct~ed sllty clay at 24". <br />Approved for one ~mesfte on 10 acres pending accept~le plot plans prior to any con- <br />s~uction. The sewage ~ystem is to be located at least 150' back from the road due <br />the shallow soil depth at ~e front of the property. <br /> <br />Agent Mal-ton County ...... S!gnatur¢ Date 5-17-76 <br /> <br /> Statement of DEQ Relative to Above Applidatien <br />( ~The above described me%hod of sewage disposal is .approved subject to the <br /> following conditions~ -- ~ <br /> <br />( ) The above described method of sewage disposal is not approved for the following <br /> reasons: <br /> <br /> , 5-_1 ._76 <br /> C. S. £HER~^N, R.$., Director <br /> ENViP. ONMENTAL HEALTH SERVICES <br /> Marion County Deportment o[ Public Health <br /> Room 220, 3180 Center S~eet, <br /> <br /> <br />