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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: �g 13 9 C Al S C Ade, tiny 6 r E Jamiiv r 2 t.. ©rc. 97381 . <br /> Township 04 Range W Section c2Jr Tax Lot 4 Op Total Acres !y A�' <br /> Subdivision ! Block Lot I '1 v L 1 <br /> _ 1 <br /> ❑ Drawn to Scale: • Not Drawn to Scale -OR- 1 square=Jo 1 feet stile MAR 17 2A77 <br /> A,PP' �= EGA FOR SEPTIC Pro l i�� iv;F� t :: ( ; 811:1-;;IV,2 <br /> - •IN, e�',LLAfIO-N ONLY" V�� VI��Ii� E <br /> It is the responsibility of the e <br /> applical to coordinate thes ei1 - 0-0 , 0 <br /> ec 6°` � <br /> require ;r;`-nts with all other1. <br /> � <br /> Lo <br /> pf <br /> c <br /> C isho d x° - .)0` - v'4- - - <br /> 3 ey <br /> . L.a2 /1.3 'r i--l'41 T^kiliNifff. • <br /> / , _ <br /> , €3 J'.3" o . - . •�J i _ 11`SSi <br /> 1 r Y 3 a.- ''7 .. <br /> /gal 1 42.11-cl-L- L ew-4'. . . r. Dev-cc\ . . . . . <br /> 41. <br /> 1 . <br /> p - -,- g17:6; STATECERTIFIED -,� Environmental Health Specialist <br /> f,+�, a`�� EH-S-1 065 0 <br /> .•.4,3,.,‘*_. .,0 0 if/, <br /> b Jec 300. . .. . CD. . X. . . • - Robert Goodwin - <br /> . . . -. . . i- <br /> 6-- o- 6 - - - . . . . . 3 al-tial, - . <br /> ��- - of0G d • r;eici- x . . - . . . . .. - r` - <br /> t~q,r rn encl.c A 340 <br /> - • -Drop -N/ l Exoa,. . _ _ .C sC A-17 E w /V <br /> I certify that the above information is accurate to the best of my knowledge.I AM THE[ ]Owner or[M Authorized Agent <br /> NAME(please print): Herbert C. Wilson Telephone# 503 - 873 - 7157 <br /> Applicant's Signature: $1Y r� 0. e d AM Date: II 1 G— d,1 <br /> Applicant's Mailing Address: 8778 Cascade Hwy. NE <br /> City: Silverton Zip: 97381 Applicant's email: lonepineseptics8778Qgmail.com <br /> S-31-1-2017 <br />