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8990535
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Last modified
11/12/2019 8:43:39 AM
Creation date
11/7/2019 2:51:45 PM
Metadata
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Template:
Permits
Permit Address
6883 KEENE RD NE
Permit City
GERVAIS
Permit Number
555-18-007012-PRMT
Parcel Number
052W34 00300
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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-00 L <br />"APPROVED FOR SEPTIC LD C <br />INSTALLATION ONLY" DRY WEATHER <br />It is the re onsibility of the INSTALLATION <br />app nt to oordinate these <br />re u' m is with all others. ONLY <br />SUE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br />Site Address: L70?3 944�IL <br />Township C%� Range Section -3�1 Tax Lot > O C Total Acres'? %C <br />Subdivision Block Lot <br />J Drawn to Scale: l ft "` 5 -l3 Not Drawn to Scale -OR- 1 square= feet <br />SEP 13 <br />2018 <br />I�®ON SPEBULNG INC -TIC <br />LU <br />(D <br />Z- - - - - - - - - - - - - - - - - f <br />17 <br />_ O <br />O Z W M?' J 6I <br />LLI O 1" <br />co M <br />0 Ln Q m o - �' G�'F-I Ute% - y,y � � - _ - - - ��/ - - - - • <br />. . . . . . . . . . . . . .. <br />[ <br />tr <br />tA <br />- ��, �'�• jam!! (� I r �/� . /� . � .% . <br />- -�-" - - •�-.�.. -� - - - - - lir------' - '`� � `�°!�� �% c �?-t �. _ _ . <br />I certify that the above information is accurate to the best of my knowledge- I AM THE (] Owner or Authorized Agent. <br />NAME (please pant): <br />G ,ova .5 �b , 67 s*X(( �i�31(.S � - Telephone # 6C)? -7 <br />Applicant's Signature f Date: <br />Applicant's Mailing Address: �' 7 / <br />Ci /,j y�y Zip: i t Applicant's email: <br />�': ° <br />S-31-1-2017 <br />
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