Laserfiche WebLink
MARION ~-'0LINT~ HEALTH D;-"PARTMS'NT <br /> <br />Serial No ..... ?~?.~.! ............. <br />Fee Receipt Nc~ 3434 <br /> <br />To: <br /> <br />SubjecL: <br /> Your request dated ........ ~T.~.~%Z~ ........................ ior property evaluation in accordance ~-th Oreqon Admin- <br /> isCative Rules, Chapter $$3, s~ions 41-001 to 41-045 (P~SA~ intormatlon). <br /> <br />Property loc~tion: Section..}J. ......... R~qe.___[..~{ ..... To~nship..~ ............ Numar o[ ~ea ....2 .......... <br /> <br />Review of Soft Maps indicates types ....... <br />?i~ld ch~k g~n~r~]Iy conforms ~o soil ~s? .__~'~ . ............... <br />SCS con,irruPtion need~? Yes No <br />W~t~r supply comments (~ <br /> <br />Non-iec~stbility comments and/or oilier restrictions <br /> <br />Copy to: State Health Division _ ' i i . <br /> <br /> Real Estate Comm'tssion /-'~Siqnc~tu~e (Reqist~[ Sanitmricm) <br /> <br />EH.Si 7/72 <br /> <br /> <br />