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12285559
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12285559
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Last modified
7/26/2024 10:50:58 AM
Creation date
7/25/2024 5:01:17 PM
Metadata
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Template:
Permits
Permit Address
3958 78TH AVE SE
Permit City
Salem
Permit Number
555-24-005343-PRMT
Parcel Number
082W11B 05500
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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a - a- „ -\,3 <br /> SITE PLAN FOR PROPOSED RESIDENTIAL DEVELOPMENT JUL 12 2024 <br /> Site Address: 3 el s—e . 4v e St 6' C rL l-7 317 <br /> Total Acres Z• if <br /> IfXIUT fNI <br /> NA Drawn to Scale: -❑ Not Drawn to Scale -OR- 1 square= feet <br /> 1 i ii i .. .. .. .. .. .. .. . ._ 9. 0 . .. .. .. .. .. .. . ‘ . . . . . . . . . <br /> f. <br /> 3 0 • - • • - -C°- '1,64- - <br /> . ; a <br /> . . , . - . ` <br /> .1 r, .1 . . . . ".----.1._,..4 . . . CA . i . ...ii CI . . . . . . . . . . <br /> Y . . . . . . . . - . . 3 . . . . 0 . '� . . <br /> - _ . . . . . . . . . . . , . - . . . . . . . _ <br /> ( SS <br /> STATE CERTIFIED liter ' • - - <br /> Waste Watte Specialist <br /> �• EH-W10147892 <br /> ,y i • <br /> fS1 <br /> n' im•er•ee A.Aldnc . ....te i5. . <br /> 1T 234 <br /> !Awl <br /> certify that the above information is accurate to the best of my knowledge.I AM THE( ]Owner or 1 J Authorized Agent. <br /> t <br /> NAME(please print): C h t^ 1 S C / / I'() Telephone# S j/ .tD —e0S— <br /> Applicant's Signature: V Date: 0 7 Id /Z y <br /> Applicant'Si1 `"s Mailingin Address: 3�51 i TJ Ave 5 e- <br /> City: <br /> City: I Zip: 17 3 I '7 Applicant's email: c ism( Hi s e W j 2.2C(:Yzt s ./12- <br /> S-31-6-2020 G:\Forms\Septic\FORMS\S-3la SepticSystemSirePlanRequirements for SITE_EVAkS_2020-07-20.doc <br />
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