Laserfiche WebLink
RETURN TO: <br />Marion County Health Department <br />Sa!em ~ Oregon 97301 <br />Phone: 588-5346 <br /> <br />, FEE SCHEDULE: <br />Non-refundable $25.00 <br />per lot to be submitted <br />with application. <br /> <br /> DESCRIPTION OF PARCE_~______________~L (Attach Plot Plan as Exhibit A) . <br /> N~rattve ~scrtption ~ <br /> <br /> Sh0~ ~on ~,p ~e~ ~s~ace s~age s~t~ '~r ~s~S on ~ pl0t pl~ <br /> which is' attac~d as Ex'bit A. <br /> NOTE: The M~ion Cowry ~al~ ~p~ent, as con~act agent for the D.S.Q,, must <br /> comple~ a site .~inves~ga~on ~fore a sta~ent u~ ~ ~given. In order ~ verify <br /> soil t~es ~d ~e~rmi~ ~s s~t~ility~ i~ is often n~ess~y to re~e t~ (2) <br /> soil ~e~t ~le~ ~ ft. by ~ 'ft, wide ~ 4 ft. deep and 75 ft. ap~t in ~e ~ea <br />prOpos~ for ~e sewage sys~. You will ~ centered if field inves~ga~on <br />indicate a need for such ~les. ~st ~les ~e re~ire~ for sre th~ one p~cel, <br />T~$ re~rt, w~n c~p~eted~ wil! ~t el~nate ~e ~ed for ~q~red <br />co~ission ~proval, building or l~u~on p~ts. <br /> Test holes ( ) have ~en pr~ed ( ) w~ll ~ ~ep~ed by <br /> <br /> (date) <br /> <br />I HEREBY R~ST FR~ ~ D~T ~ ~ViRO~NT~ QU~TY A <br />OF THE ~ ~THOD OP SEW~E DI$~$~ ~R ~ ~ D~CRIBED P~CEL. <br /> <br />~ess of A~plic~t /~ ~~ ~6 Title "- - <br /> <br /> (fo= ~ ~ ~ent ~e only) <br /> <br />~ents ~d re~endatto~ ~ased on $~ace 'Si~ ~ves~gatfon by D~ or ~n~act <br />Agent: <br /> <br />S~il is Simila~ to Nekia silty clay loa~. Silty Clay at 24", <br />Approved pending acceptable plot plan prior to construction. <br /> <br /> <br />