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10512297
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10512297
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Last modified
6/25/2021 8:00:13 PM
Creation date
6/25/2021 11:25:55 AM
Metadata
Fields
Template:
Permits
Permit Address
33299 NORTH SANTIAM HWY SE
Permit City
GATES
Permit Number
555-21-002255-PRMT-01
Parcel Number
093E25C 00400
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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SITE PLAN PO r": P OPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: 33',2,9 y N. rL-i't,12.01 MA q G17--+C.C.1 G R .- �. j i1 -- . r <br /> Township - 11 II <br /> Range Section Tax Lot Total Acres .9 i <br /> g 11I i <br /> Subdivision Block Lot, P);,.! E 1 1.� MAR 0 5 2021 1- . <br /> El Drawn to Scale: °lI Not Drawn to Scale -OR- 1 square= 5 feet ,f;! f4i-. v <br /> ''L L ', `,IG iNSPECT;iON <br /> . . . . . ' • rJl. . - -- 1.—L.0.& . . . . . . . .6uHn. o�'fi5e�4'',0�' . . <br /> .__ . <br /> i�,e► :1.11 i9 G.�i f t<- - f r . -6- <br /> kucp- - /'���pas PPROVED FOR S -:PTIC • <br /> `"• �1 INSTALLATION 0 'LY" • • <br /> L , IfeAl I , t i the respo ibility of the . <br /> -II �; 5 . 5.4)r � ap Iicant to c.t�- ,in a these <br /> �--$ , ;":3(' <br /> r uirements w all others. <br /> ‘,.11 U . <br /> u <br /> x � . kiaut. �r �," . 4 . . ., . . . ..- . . <br /> _ I � i• I.>c--ai . Oul ird �\ <br /> . . . . I— . . <br /> • ,-- <br /> A., ED• • • • • • <br /> • <br /> z j`. �- • • STATE CER FFIED • • <br /> Environmental Heal Specialist <br /> ' • ! •1$ 1 <br /> . , iP,31 4 0• '.-, • <br /> / ....----- _____ _______ . . . . . Robert•Goodwin <br /> 3172P1 ' " <br /> I certify that the above information is accurate to the best of my lmowledge.I AM THE[ ]Owner or[ ]Authorized Agent. <br /> NAME(please print): .i ar44/.e 5 Pi- )-t/eel Perin Telephone#C.SW 9'7y_ a l ' <br /> Applicant's Signature:24 2fr7� t�G/ �•' Dater/5/R-/ <br /> Applicant's Mailing Address: 17 Box L-15Li <br /> City: 0-7,C-te,.. Zip: G17316 Applicant's email: i bo 6)3 g,5,5. eCeO'1 rxi/ ? CU.1" - <br /> ,..1 <br /> S-31-1-2017 <br />
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