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SITE PLAN MUST SHOW ALL PROPERTY LINES AND DIMENSIONS <br /> CIDrawn to Scale: 1 square= 5 -fCe"LI- Feet Not Drawn to Scale:Total Acres <br /> -- l ' Serk, .by 45® <br /> A -6 R�. 24' . . . - . [iAt. ?ink . luo;7 ' A/Dr <br /> A . I. ..3q.' . . . ' . . . . - . . . . 1 r-.tit. wii . 190 c '. . . . _ . . <br /> R 49 -'- .51.' . . . . . . . . . . . l,t . ff&1 . . too 5 _ . . . . . . <br /> s49 g = .17' . . . . . . . . _ . I Jr1e blvC. _ iPt 3 • - . . . <br /> . sfa ur= 33.- . . - Ne (9.1-eevv _ gq,g.:. -: <br /> R Q <br /> d�' STATE CERTIFIED . <br /> 15�pp Ifir Environmental Health Specialist <br /> 7�0 V .1'a, EH-S-10227575 <br /> --*• <br /> "4----*--- -I- • 'y • .• <br /> . . . _ . .7 V6 . . . . . .. \I . <br /> r � . . . - . <br /> =; _ . r. <br /> • 'APPROVE 'FOR SEPTI ' \' - - . <br /> INSTALLATIO QNLY". . . . . . . . . . . . . n• . . . . . . . . <br /> It is the responsibility iiIihe, . J • • - _ . : - - - <br /> applicant to coordinate these - . '3 . <br /> requirements with all others. . - • <br /> Aril, •r ' eir - • <br /> - - - . . �.. <br /> Ar�c SiDe- Dt QropoceD <br /> I certify that the above information is accurate to thebest of my knowledge.I AM THE[ ]Owner or[ I Authorized Agent <br /> NAME(please print): /r y 4 NC/ 2 Telephone# �0?— c.P-70 Z' <br /> Applicant's Signature: �, lam/14. ���L•�%!v g Date: 9 'Oa 3 <br /> ' *ailing ess: 6' 0 3 //�� 4 ,r- City:/ d C ? Zip: 9707/ <br /> Applicant's M g � �v fed" U+� G^�'��Rd <br /> FOR OFFICE USE ONLY <br /> PLANNING. Date:PUBLIC WORKS: � (� E �' <br /> BUILDING INSPECTION (Acceptable for Planning requirements only) Date: I�l <br /> f---) <br /> MARION COUNTY <br /> A-33D BUILDING INSPECTION <br /> rev: 05/2011, 9/2012 " <br />