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NAME: <br /> <br />ADDRESS: <br /> <br />SECTION: '~/ TOWNSHIP: gS RANGE: <br />TAX LOT NO:JD~p~ OS,.,, ,,~3~/-f~-- <br /> <br />SITE EYALUAT%ON <br />FILE NO: <br /> <br />~ ~ -~iii~'.~'l|;Jlll/' II IIIIIII <br /> <br />#1 #2 #3 #4 <br /> <br />SOIL <br />Eff. Soil <br />Depth <br /> <br />SYSTEM MUST INSTALLED AS SHOWN: <br /> <br />Test Holes: 0 = Acceptabl <br /> <br />table <br /> <br />SYSTEM DESICN <br /> <br />Daily Sewage Flow: <br />Tank: <br />Drainfie <br /> <br /> ,~eu <br /> <br />System:. <br /> <br /> ~ench Depth: <br /> <br />Rock Depth: <br /> <br /> Backfill: <br /> <br />COMMENTS: <br /> <br />This document is a <br />to a permit only if, <br />with applicable <br />measures or the S1 <br />a construction <br /> <br /> report on-site only. It <br /> <br /> the gime parcel been <br /> ged ~ive land us~ <br /> Planning Goals. Agent <br />can be issued. <br /> <br /> ~atible <br />g <br />before <br /> <br />The proposed site of the sewage system installation has been reviewed and approv, <br />Marion County Sanitarian. <br /> <br /> PERMIT NO: <br /> DATE: SANITARIAN: <br /> <br />the <br /> <br />This permit expires one year from date. <br /> <br />flRF/car <br /> <br /> <br />