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11190173
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Last modified
8/18/2022 1:43:53 PM
Creation date
8/11/2022 4:44:22 PM
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Permits
Permit Address
3511 MEMORY LN SE
Permit City
Salem
Permit Number
555-21-005066-PRMT
Parcel Number
083W25D 00501
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: _157 Sq few). 9 23/7 /Vic-kir <br /> Total Acres <br /> TAXLOT <br /> ❑ Drawn to Scale: -I Not Drawn to Scale -OR-= 1 square= _feet <br /> -PALS - )- 4-66a et- .. - • - - - - - -o. - - - - • - - • tea, • - <br /> . . . . . . . . . . <br /> f ® J- , 'er <br /> — .--7----tis,,---:—'-----------?------ ' - <br /> A itte „ <br /> a <br /> - It • . . - - • F t�• - <br /> �(„ '..-w_.� . " °l . . . - • - - - - - . . . <br /> 7' 1 D 3a`[ <br /> " - . _-__Li_OLC - . (4-S‘"7-'" - - - - . . . . . . . . . <br /> fi'> • ' - - - ,>,,,,,,",,e4;,.'' . - - . - <br /> r d , <br /> "APPROVED FOR SEP Diu t ' <br /> INSTALLAT ON " �� �� . . . ./ . . . . . . . . <br /> it is the responsibIONility OftLYh '(\ " <br /> applicant to boOrdmnate these f _ / / <br /> requirements with III others. .,- <br /> f r �' fwTaAsieL : <br /> E ecialist r <br /> O> 01i47892 <br /> i / PPS. t • �� ' �/ L� i <br /> �' Kirnberlee A Aldrichf ,.... - i r�- <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•print)`] .r i RfouCI ISC :Telephone#1403) �' ' r Coral?6 <br /> Applicant's Signature: ,„, r Date: QS—ER-Al <br /> dd° X Applicant's Mailing Address: r <br /> n <br /> City:/J C rt `Zip: 7 t Applicant's email: € �tf°°,?A Y1 <br /> r :o "k 1 l�1O i A cowl <br /> S-31-6-2020 G:Worms\Septic\FORMS\S-3Ia SepticSystemSitePlanRequirements for SITE_E ALS 2020-07-20.doc <br />
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