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i . EA1 . -ECIEVElt <br /> SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> APR 132021 — <br /> Site Address: <br /> 39O�a gall/CQ(j ,41/e G�Cr o �2 M.�RiOiq COUNTY <br /> / / BUILDING INSPEGFION <br /> Township 9' Range tit--- <br /> Section_3() Tax Lot JIQ/1 Total Acres <br /> Sul vision Block i Septics <br /> . Drawn to Scale: • •❑ Not Drawn to Scale.„f _ <br /> ••'' 1 square= 1 5$5-21-003820-AUTH <br /> _ -r" +n: • • • I CHAURAN,CI NDY <br /> • I 34020 RAILROAD AVE SE, GATES <br /> ' -`I 'QTS 9ITR PLAN•fN,fAS P BARED <br /> 4--- 094E30 01600; 1.10 acres <br /> BIX THE ADPLICANTA USED POR rt, -'r <br /> REVIEW OF THE EXIST G SEPTIC 161. <br /> , . <br /> . • SYSTEM.ACCURAG,XO THE SITE 0A }} '`� i G, <br /> . .PLAN CANNOT B ARANTEF0. -' ;--'e <br /> 7 I <br /> *r. <br /> r' r�`:2L � t.t <br /> ' r e• �� ; ; <br /> ofeel <br /> . ,! ct. F�.vy�'1F Com'' �S'4,i7'�s <br /> F air r - 7 <br /> • <br /> �` � . _ _ �''� i --- ,,— IIra.' _ 4 . <br /> ,',saiPr 11i <br /> 4,uiI graIi :i •0 1 it .. <br /> I 1 epic_ •it <br /> it 1iI .' S all . . • . - . • . . <br /> Ie� ' • • • STATE CERTIFIED • • <br /> r , Epvirortmental Health Specialist <br /> I' "i. p i ;.' �;; EH-S-10 40 <br /> • <br /> i . I. y J�• <br /> j/J//�///j <br /> 161 <br /> • <br /> y-=. .--�� 1 j Robtrt Goodwin <br /> 1 I .„.7.,..,..,,"-,kibt'45 6 4 <br /> 5'4 • <br /> i\r(1t. . •. . •. <br /> • <br /> I certify that the above ..intim is accurate to the best of my knowledge.I AM f•Hfi.1 1 Owner or[ ]Authorized Agent. <br /> NAME(please print): / /?(-2 Q ,a7117 Telephone# 5 E2 QC)// / ,9,c <br /> Applicant's Signature: ,_.e''',.. "-/-:--",,, ��/�� Date: ' G/�T/,G-�� <br /> Applicant's Mailing Address: /Dad ga(7.1 g ' e <br /> City:_,.C.7.�' .A Zip: 92/ 7Applicant's email: (_la,,,ra l/. e t e.:,-,--/-, <br /> S-31-1-2017 <br /> 1 <br />