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~ETUmS TO: <br />Marion County Health Dep' .~--~ <br />31s0 Center S~. ~, ~oo~ <br />Salem, Oregon 97301 C~e <br /> <br />DESCKIPTION OF P~CEL (~ttach Floz ~lan ~s Exhi~it A) <br /> <br /> Set # ~--98-1~ <br /> DEPARTP~{~T OF .~NV~O~MEN~AL Q~ALITY <br /> ~ FO~,: ' Rec ~81~9 <br />STATEMENT OF F~SIBILI~ FOR P'~OPOS~D '~U~SU~ACE SEWAGE DISFOS~. <br /> Pl~ntng ~ ...... ,,r, FEE SCHEDULE: <br /> Non-ref~dable $37.50 per <br /> to be submitted with <br /> application. <br /> <br />~ ~ ~ ~ ~ 7 .... I~ -,~ ~-~7-~'~ ' <br />p~fOSED USE~F P~CEL (N~ER OF He. SITES) AND LOT ~IZE(S): ~ ~j~.~ 7~ ~~ <br /> <br /> ~f for a comme~ o~restaurant, we nee~ to know the number o~ Jmploy%~ and/ <br /> or the seating capacity: ~_.. <br />PRESF~TLY DESI~ATED L~D USE, ZOMING, ~D ~ OF DESI~ATING AGENCY: <br /> <br /> TEST MOLE Pd%QUIREM~TS: <br /> One Romesite: You will not need to dig test holes unless notified, <br /> Two or More Homesites: ?~o,test holes.must b~ preoared on each parcel, 2 ft. by 3 ft, wide <br /> and ~ f~..deep~ and 75 ft. apart in the propoaed areas, <br /> Te~t hol~s ( ) h~ve been prepared '~ wi%% be prep@red-by ~-,/- 7~ <br /> (date) <br />~THIS REPORT IS NOT A PERMIT. It does not eliminate the need for required planning commi~ <br />~sion approval, building, or location permits, <br /> <br />I HEREBY REQUEST FROM THE DEPARTMENT OF ENVIRONMENTAL QUALITY A STATEMENT 0F FEASIBILITY O]. <br />THE ABOVE METHOD OF SEWAGE DISPOSAL FOR THE ABOVE DESCRIBED PARCEL. <br /> <br /> Signature of Applicant <br />Name of Applicant '~'~ ~'i t~ '.~?.$~u~ Title <br />Address of Applicant ,/~M~3./ff-.,~.~e~/l~_, z?Q't93 ~Ow~er~ BuYer, Agent ,.. <br /> <br />c ty, State, Code ete <br />***************************************************************************************** <br /> <br />Coraments and reeom~:endattons based on Subsurface Site Inveetigation by DEQ or Contract ABeT <br />Soil is similar to Salem gravelly silt loam. <br /> <br />Approved for two homesites with disposal fields to be placed aS shown on the attached <br />plot plan. Utility easements for such placement will be required prior to issuance of <br />permits. Effluent pumps will be required to develope the two 'lots. <br /> <br />The third iot might be approved if adequate acceptable soil was located in the area <br />near Mill Creek Rd. <br /> <br /> "Present this evaluation when~a.pplying for <br /> building permits. Fees for individual lots. <br /> that are approved, re. ay be append ~ perrni~ <br /> ~..tn :: <br /> <br /> B .................. ,gn // ' - - ~'~ ~a~e . _ <br /> <br /> Statement of DEQ/Contract Agent Relative to Above Application <br /> <br />(wi~ The above described method of sewage disposal ,is approved subject to the following <br /> <br />( ) ~e above describ"--~x-ed ~thod of sewag~ disposal is not approved for the following reasor <br /> <br />For ehe DEQ/Contrae~ ~gent= ................ Date <br /> <br /> <br />