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RETURN TO: <br />Mauioo County Health Departn~ent <br />31$0 Center St. NE, Room 220 <br />Sa] em ~ Oregon 97301 <br /> <br /> DEPAR'II~ENT OF E.NVIRONMENTAL QUALITY sar. no. 6-76-77 rec. ~/2098 <br /> FOR <br />~TA~ENT OF F~IBI~ FOR ~ROPOSED $~MU~ACE ~WA~ DI~OS~ <br /> <br /> Non-ref~dable $25.00 per lot <br /> <br />DESCRIPTION OF PARCEL (Attach Plot plan aS g~hibit A) <br /> <br />Show location of proposed substrata sewage sy~t~ ~/syst~ms on the plot pl~ which <br />att~che~ as ~xhibtt A~ <br />~rE: T~ MarioY~ Co~ty Health ~p~nt, as con~act agen~ for ~he D.E.Q.. must complete <br />· ~ site iflvestig~tion ~fore a statement c~ ~ given, ~ order ~ ~erify soil t~es ~d <br />determine ~s s~tsbility, it iS often neoess~y to req~re two (Z) soil test ~les <br />by 3 ft. wiOe and 4 ~t~ deep ~ 75 ft. ap~t in t~ ~ea proposed for the sewage <br />You will be con~cted if field investiga~on indicates a n~ed for such ~lus. Test ~les <br />~e required for mor~ th~ one p~Cel, ~ig ~rt~ w~n COmpleted, will not eliminate the <br />need for required planing c~ission appr~val~ ~ldlng or Ideation <br /> <br /> (date) <br /> <br />~ MEREBY REQ~3g~T FROM TH~ D~AR~ OF g~/RON~NTA~ QUALITY A STAT~ENT OF FE~IBILI't~ <br />THE A~VE ~THOD dP S~AGE D~GPOSAL ~R ~{E ~VE D~CRIBgD PA~CgL. <br /> <br />q,-~l i[ similar to -~ifton gravelly loam. Gravelly loam at <br /> <br />pending per--it app].catzon. ~ewagc disposal system~ to be pl,~eed on highest <br /> <br />...... --,, , oa~ 6-29-76 <br /> <br /> $~ment of DEQ Relative ~ Above Application <br /> <br /> <br />