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Envirommental tfealt~ ~Servic~s Division <br />~u~ion County D~ o~ Public Health <br />S~l~m, Oregon 97301 (~88-82~6), s~en~ for: <br />Department of Enviror~r~n~l Qu~li~y <br /> <br />To be ~mt~mltt~ with applica%i~ ~oF <br /> <br />Application ~o the D~P~a~ of EnvironmenZ~l ~3 i%~ <br />for ~ ~t tO Oon~truct a Ne~, or ~ <br /> <br />Permit F~: ~ew - $~0.00 ($2§.00 with site evaluati~) <br /> <br />R~oair, Alter~tioa - $15.00 <br /> <br />Ig%~NCE iN~TiGN <br /> <br />~of Apprican~ .... <br /> <br />New Censtru~ion ~ .~ _ <br /> <br />Inst~llation will ~_~ve: Ho~se ~/ <br /> <br />Mobile H~me <br /> <br />Cc~me~ci~l Buildi~_ <br /> <br />Number of L~vi~gUnit$ <br /> <br />Water Supply: Pablic. <br /> <br />1. ~ ~m~u~r~e ~ Disposed ~y~tm Plot Pl~ <br /> <br />Planning Ev'alu~ion ~ ~milding l~t <br /> <br />Building Plus <br /> <br />]~§7 7/74 <br /> <br /> <br />