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NAME: <br /> <br />ADDRESS; <br /> <br />SECTION: NGE: /tO <br />TAX LOT NO: <br /> <br />SITE EVALUATION <br />FILE NO: <br /> <br />#1 #2 #3 #4 <br /> <br />SYSTEM MUST BE INSTALLED AS SHOWN: <br /> <br />Test Holes: <br /> <br />0 -- Acceptable; <br /> <br />Not Acceptable <br /> <br />III <br /> <br /> SYSTEM DESIGN <br />!'Daily Sewage Flow: <br />'Tank: /~¢~ <br />Drainfield: ~7.~TM <br /> <br />Dis tributJon: .5~'~_ / ~94__ <br /> <br />Type of ,,,System: <br />Trench Depth:j~ <br /> <br />Rock ~epth: <br />Minimum Backfill,: /~' <br /> <br />C0~ENTS: <br /> <br />-! <br /> <br />~is document is a technical report for on-site s~age disposal only. It may be converted <br />to a petit ~ if, at the time of application~ the parcel has been found to be compatible <br />with applicable LCDC-acknowledged local comprenhensive land use plans and implementing <br />measures or the Stat~ide Planning Goals. Authorized Agent approval is~q~red~efore_ <br />a construction per mi~ can be issned. I///~. ~---" <br /> <br />The proposed site of the sewage system installation has been reviewed and approved by the <br />Marion County Sanitarian. <br /> <br />PERMIT NO: __8~.7g? <br /> <br />DATE: 5-17-84 <br /> <br />SANITARIAN: <br /> <br />This permit expires one year from date, <br /> <br />RRF/car <br /> <br /> <br />