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n/S_ITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT <br /> Site Address: 2S C0 /) jJc*L 0-- 1 y0LA-S <br /> Township Range Section Tax Lot Total Acres EXPIRE D <br /> Subdivision Block Lot <br /> ❑ Drawn to Scale: •❑ Not Drawn to Scale -OR- 1 square= feet <br /> /7' <br /> .Q. <br /> �BD <br /> - c ,a.Ik K,° <br /> �.,•5-�-�,4- .. b :<r:tD�k�"`'a`'. . . . . c ' . ,i). . . 0 ,,b,. 060 es - <br /> f.-o •?Y<�Ge4— {✓•s)(I.vi- 4-fr.--4.c. . . ., •. . - / . . <br /> 4tc2NN t�SC OVh� pry.^{,fij . `1 ,Z (tea % <br /> • ekct�;cul • i„S/ r o cc¢ 't . ' ). . ./ . ... . . . . . . . .. . :1/4 kiv 'i$ • lnu► • ct <br /> 0f:10..4 / , <br /> i✓d Low G1t*..0,,j <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> "APPROVE FOR SEPTIC <br /> . INSTALLATION ONLY" <br /> STATE CERTIFIED . It is the res•ponsibility of the <br /> Environmental Health Specialist <br /> �, `�- EH.s to2os5ao applicant to coordinate,these <br /> r <br /> requirements with all others. <br /> Robert Goodwin <br /> I certify that the above information is accurate to the best of my knowledge.I AM THE[ ]Owner or[ I Authorized Agent. <br /> NAME(please print): Herbert C. Wilson 1 , ,, Telephone*I 503 - 873 - 7157 <br /> IN, <br /> Applicant's Signature: C `. n{ Date:f— "al <br /> Applicant's Mailing Address: 8778 Cascade Hwy. NE v <br /> City: Silverton zip. 97381 Applicant's email: lonepineseptics8778( gmail.com <br /> S-31-1-2017 <br />