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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT r <br /> 91 [1U E <br /> Site Address: D 3'lG 5' l z. z D ' D <br /> L e rl s ir? 2- Y 7 3 5 Total Acres 0.7; J U L 30 2021 <br /> TAA"L <br /> jiik Drawn to Scale: •❑ Not Drawn to Scale -OR- l square= /G feet MARION COUNTY <br /> BUII DING INSPFCTION <br /> Septic Site Plan <br /> 555-21-007754-PRMT-01 <br /> ELLIS,KAREN S <br /> • =------.--- 28681 NORTH FORK RD SE, LYONS <br /> 093E18BA01200; 0.72 acres <br /> f <br /> . . . . . . k".iA D . . <br /> 1 l <br /> a j <-i _ <br /> fN*C,- <br /> . . is/7./1 <br /> • 6; i <br /> . . . . . <br /> .. . // 1' - R - <br /> • EXPIRED . <br /> / i <br /> . \ <br /> • vk <br /> ' / <br /> I <br /> NI'1 rp r I !— <br /> I certify that the above information is accurate to the best of my knowledge.I AM THE I ]Owner or 4 Authorized Agent. <br /> NAME(please print): Te -/- / /1 t ,ot7/— r Telephone#l,��.3 7 9,3 R -c9 57 <br /> Applicant's Signature: 7.,4..A7 1�/t,ii"'� 1/ Date: / -2 7-6 <br /> Applicant's Mailing Address: /S S 3 �G 4 e 4!/G P <br /> City:` +t' L'h7f) Zip: 973533 Applicant's email: (7.11[_? . y0-/Ir-i- . C-j/7) <br /> S-31-6-2020 G:\Forms\Septic\FORMS\S-3Ia SepticSystemSitePlanRequirements for SITE_EVALS_2020-07-20.doc <br />