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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT ® I MVE <br /> Site Address: Z- L- 4 CP-.o 4c'r ,.� .04 JUL 2'� 2021 <br /> '' MARION COUNTY <br /> TA�a•ot o* ,►. r"�rx:� f:� , S Total Acres_ BUILDING INSPECTION <br /> ❑ Drawn to Scale: ilik,Not Drawn to Scale -OR- I square= feet <br /> 440: datiti <br /> a ♦ ♦ . . ♦ • r • • •. • ♦ • . «. j • • • •. . ♦ • ♦ <br /> • VIE® FOR SEPTIC . <br /> INST'ALLA'TIO <br /> . It♦is the rasp®nibllitjr' the it. • . . , <br /> e�l'st,ky e'D <br /> A applicaht t® cobrdirlate these• r N <br /> requirements With all others.• <br /> $tom' <br /> S <br /> STATE CERTIFIED <br /> . • , • 'Environmental Health Spedatht <br /> • • • �,: > EH-5r1I 65',' • <br /> -et" p <br /> •bert Goodwin <br /> • <br /> I certify that the above Information is accurate to the best of my knowledge.I AM THE If er Owner or( I Authorized Agent. <br /> NAME(please prints i* Atom,ir, f Telephone!i �r zee-,47,r{ ... <br /> Applicant's Signature: Date:. <br /> Applicant's Mailing Address: ZQ^b—,. y +.s&rs 41 j ..ern s.r ' ' <br /> City: ltrainsd Zip: O N.? Applicant's email: ita !��t.— 7.7ek v Gpm._, <br /> S-31-6-2020 G:\Forms\Septic\FORMS\S-3la SepticSystemSiiePlanRequirements for SITE EVALS 2020-07-20.doc <br />