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MARION COUNTY BUILDING INSPECTION DIVISION <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503)588-5147 <br /> Fax: (503)588-7948 <br /> LAND USE COMPATIBILITY STATEMENT (LUCS) <br /> FOR ON-SITE SEWAGE SYSTEMS <br /> DATE: 6/4/2024 MCBI File#: <br /> SECTION 1—APPLICANT IlVFORMATION <br /> l. Property Address: 450 N Santiam Hwy W Property ID#: <br /> Gates,OR 97346 <br /> Section: 09S Township: 3E Range: 27DB Tax Lot#: <br /> own <br /> 2. Name of Applicant: Tyler Fuhriman.WWS Telephone#: 435-760-0717 <br /> Mailing Address: 8727 SW 19th Ave. Portland.OR <br /> tyler fuhrimanconsulting.com <br /> 3. Describe type of facility the on-site sewage system will serve(business,residence or other): <br /> ❑ Single Family Residence <br /> El Business <br /> ❑ Other: <br /> 4. Type of on-site sewage system permit application being proposed for this property: <br /> ❑ New Installation Permit <br /> ❑ Repair Permit <br /> El Alteration Permit for: Ell Replacement Dwelling l Bedroom(s)addition <br /> ❑ Other changes in land use involving potential sewage flow increase: <br /> System#2. Connect 2 RV pads and 1 Mobile Home to existing septic System <br /> G:\FORMS\SEPTIC\Application Packets\S-39 LUCS.doc MC:S-39 rev:8/10,04/12 <br />