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ADDRESS: <br /> <br />TAX LOT NO: <br /> <br />SITE EVALUAT% 0N <br />PILE NO:: _ <br /> <br />Test Hole~: <br /> <br />Acc~p tab le <br /> <br />This document tS a technical repor~ for o~%-s~te se~ag~ disposal o~ly. It ~y b~ COnverted <br />to a p~r~t o~ if, at ~e [im~ of applic~tio~, the ~rcel has ~een foun~ to b~ compa~ibl~ <br /> <br />meas~;r~S or the Stat~ide Pla~ins Goals, ~t~rtzed Ag~ appr~al is ~e~ire~before <br /> <br />The proposed $i~e of the sewage $yste~a installa=ien has been reviewed and~ a~app red by the <br /> <br />permit expires one year from date. <br /> <br />RRF/car <br /> <br /> <br />