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APPLICATION TO <br /> DEPARTMENT (~ ENVIRONF~NTAL OUALITY s=r. uo- 7-76-8 r~¢. #3745 <br /> FOR <br /> STATEMENT C~ PEASIBILITY FOR PROPOSED ~UBSURF.-%CE SEWAGE DISPOSAL <br /> RETURN '1~0: FEE <br /> <br /> 3180 Center S~. NF-, Room ~20 t.o ~ s~bmftted with <br /> <br />DE~IPTION OF P~EL (Att~h Plot PI~ aS ~bit A) <br /> <br /> ~. /~-~,~ ~, ~.~; ~ , ........ , ~ · <br /> <br />attac~d as ~hi~t A. <br />~E: ~ ~ion ~ty ~alth ~p~ent~ as con~act agent f~ ~e D.~.Q., must c~plete <br />a s~te investiga~on ~fore a sta~nt c~ ~ given, ~ order ~"~verify <br />dete~lne ~s suitability, i% is often necess~y ~ re.re ~o (~) ~il ~st ~les 2 ft. <br />by 3 ft. wide ~nd 4 ft. d~p ~d 7~ ft. ap~t in ~ ~ea ~Do~d' for the sewage syst~. <br />Yo~ will ~ con. ted if field inves~ga~on inOicate$ a ~d for ~uch'~les, Te~t <br />~e required for more ~ o~ p~cel. T~s ~rts w~n complete, ~11 not el~lna~ t~ <br />need for r~r~ planing ~is~ion aDproval~ b~lding or loca~ ~its. <br /> ~st ~les ( ) have ~un prepped ( } will be pre~ed ~ <br /> ( dat~ ) <br /> <br />I HEREBY REO~T FROM T~ D~AR~T ~ E~IRON~NT~ QUerY A STAT~NT OF F~IBILI~ OF <br />THE A~VE ~T~D OF S~AGE DISPO~ ~R ~E ~VE D~RIBED <br /> <br />Address of ~plic~t g~/ ~, ~/~/~r/ Title <br />City, State~ ~p ~de ~.~ . ~/ ~/3 Date ~-. ~- <br /> (for ~Q or ~en~ use Only) ' ~,-,~.f'~ <br /> <br />~ents a~ rec~nda~o~ ba~ on ~s~fa~ Site ~ves~ga~on by D~ or Con~t Agent <br /> <br />Soil is similar to Sifton gravelly loam. Gravelly loam at'24". <br /> <br />Approved pending plot plan showing sewage on very highest part of this lot. This plot <br />plan is to be submitted with,the penni~ application. <br /> <br /> statement of DEQ' Relative ~ Above Application <br /> <br />above described method Of is sub ect to the <br /> <br /> <br />