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SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT ► n r fl <br /> ti � <br /> /��� �+ Q /� /� '� 'ail' 1 <br /> Site Address:p�..(AC & /Viet./A &kn./ oK. 1 .5-y�h J(�N 1 r 2022 +"Ji <br /> Township Range Section Tax Lot Total Acres ?" <br /> IViRlti i (_;' ;,J ;;y <br /> Subdivision Block Lot airlLDiN„'NSFF{DTI -)N <br /> Si Drawn to Scale:5 ' .o Not Drawn to Scale -OR- 1 square= feet <br /> . . . . . _ _ _ . SeAtic_ Sit_a Plan . <br /> eV -04; 555-22-005281-PRMT . <br /> /Fk 3,4,+ t L I UNKNOWN <br /> r/y <br /> • 2664 BODHI LN NE,SALEM <br /> 1'� . . • - • - . - -TEMP MC,0 acres - • <br /> ale2- `St, 1./• . - - . . . _ . L' -z&•-)/3CBGU?a/ Z.Z1.-,4c._ - - <br /> /, 33y" .± <br /> 1,,, <br /> :r,c'/ .3'3" / <br /> z" f t,,., . . . . . . �. . /" —. , . <br /> . . . _ . . . . . . . . - - - . . . . . . APPAOV D.FOP SEPI`I a <br /> . . . _ . INSTA IlATlQN l` L �� <br /> • It is the re.p'onsibility o` thl <br /> applicant o coordinate .he se <br /> - - • - • • . • . . . • . - • • - - - • requireni:rits With all ethers. <br /> u <br /> . . . .. .(/ : <br /> B. r.1 P� 'd <br /> ..s.:L5=j) . . . . <br /> °:i . li . . . . . 13-----,,,,5.,, ,-„K <br /> ' r TPA STATE_CRTIFIED <br /> ialist <br /> " Orb : A 15+ eb. Environmental Heil h Sped f <br /> ay 'r;r,i�n/• Ole Yr �:c�j . <br /> p&- d - #i • • • Robert Goodwin_ <br /> 1 certify that the above information is accurate to the best of my knowledge.I AM THE[ j Owner or[ j Authorized Agent. ` A <br /> a. <br /> NAME(please print): p y-; J-+ t,{(,1So n .1 r Telephone# 5°3- S 73-7/5 7 VOA` 1 a,�u <br /> / r 111""" i <br /> Applicant's Signature: Date:sly ,per <br /> Applicant's Mailing Address: g77 F (?e SC'.cJ. �,..,y R/L� - , \\ J►" <br /> City-.Sr<VPJ--,o n D/2 Zip: g 73 8 I Applicant's email:40.ee.Rie.e S2.O,L'GS 9.77 Jr g GirKi;1,Can1 <br /> S-31-1 2017 G:1Forms\Septic\FORMS1S-31 a SepticSystemSitePlanRequirements for PARTITIONS 1_11 2017.doc <br />