Laserfiche WebLink
FOR <br /> STATEMENT OF FF~ASIBILITY FOR PROPOSED SUBSUF. FACE SEWAGE <br /> <br /> Marion' County ~{ealth Depar~ntD~: ........ - ...................... ~Non-ref~ndable $37.50 per lot <br /> 3180 Center St. N~, Room 220 No ~lZ~ to be submitted with <br /> C~e ............................................... application. <br /> Salem, Orego~ 97301 (Zone ~e, P~fl~on, s~v, <br /> <br /> ,Qj~_~I~I~N O~ p~CE~A (Attach Fiot Plan as E~lbit A) <br /> Section 2~ ; Township y.~ .; Range =~ .; 9o~ty of~o~., Oregyn; Tax <br /> Narra~iv~ Description: . . ' ~ . ~ ~ j ' ~.~ ~ ~ ~ <br /> <br /> i~"~"2o~ai, b'~ine~s 0~"re~tau~at, ~e need t;~umber of e~ployees and/ <br />~ or the seating capacity: <br /> 'PRES~ANTLY DESI~AT~ L~D U~ ZONING, "AND ~' 'SF DESI~ATING <br /> <br /> ~o o~ More Ho~sltes; ~o test holes ~st be prepared on each parcel, 2 ft. by 3 ft. wid~ <br /> and 4 ft. deep, and 75 ft. apa~ in the proposed a~eas. <br /> Test hol,~s ( ) have been prepared ( ) will be prepared by ..... ~8a~e) <br /> <br /> ~IIS REPORT IS NOT A PE~IT. It does not elimioate the ~eefl for required planning co~is- <br /> sion approval, building, or location permits. <br /> <br />I HEREBY REQUEST FROM THE DEPARTMENT OF E}~VIRONHENTAL QUALITY A STATEMENT OF FEASIBILITY <br />I]~E ABOVE METHOD OF SEWAGE DISPOSAL FOR T}llt ABOYF~ DESCRiBBD PARCEL. <br /> <br />Name of Applicant ~ Signature of App~-,,y~(~_~j ~t ,~' <br />Address of App]ican~ ~o~ ~ ...... Title ~ A~nt ,, <br /> <br />Comment~ and recommendations based on Subsurface Site Investigation by DEQ or Contract Age <br /> <br />Soil is similar to Jory sil~ clay loam. Silty ~lay a'~ 2z~". Approved <br />pending speci£ic plot plan wmth permit application'. <br /> <br />agent .Mmrion .Co~_q~ Signature Date ;¢'-.¢7-/7 <br />******************************************************************************************* <br /> S~atemeet of DgQ/~entract Agent Relative ~o Abo~e Application <br />('~ha above described method o£ sewage diepoaa% is ap~p_t;iL~, s~bjea~ to the following <br /> conditions: <br /> <br />above described method of sewage disposal is not approved for the following <br /> <br />EH-.50 Rev. 1,1,/76 <br /> <br /> <br />