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Oregon Department of Environmental Quality <br /> Provide a Site Plan in the space below: Show the actual or best estimate measurements of components <br /> that were confirmed during thisevaluation;septic tank,soil absorption system,property lines(if known), <br /> easements(if known).existine structures.driveways.and water suoolv(water lines and wells). <br /> 1 ) SITE PLAN MUST BE_ D• _RAWN TO SCALE 1 <br /> / __A____I Rf.C.111tEn I ! , i '.-- itS I r „ . , ; • ! * <br /> 1 <br /> flf�bR�N`COU'NT I._.e._.._._..._ .�. _.a._ a....._. <br /> • <br /> BD LDi INSPECTION = l' i.__...�.._-y-...« ...._. .. t... ..,_«e... a�«-;�- .j... »..«._..- -t.. _.� ., <br /> t � !'� F i� ! i � f �y! � t <br /> •-a--- •-f. 1 , •y•-••--4. -2.- t i i... ' . ..> . -4: ' ..." 7' .i f••• -4— <br /> V--.N.. . . 'rt.. .._e._._....._._a..... � • I . <br /> a«._... ... _..�_ a_ _ f _..L__..�_.:_. ],l;�y+ 1... <br /> 222 - .... ... -•„ <br /> s i t•• i �.j. —o <br /> i i _.4:44..gf ' f \\ x - . 1 i <br /> it ♦l <br /> iJ)tr <br /> »f <br /> ..l_...».a .i._.._.i»._._.£. a 3• i �+n.-- _.�». _. a <br /> ! 4 N ...._. <br /> . i ._._.. ..q_...._.._._.e. _.._.._.. ........._. ...p a.....,a....a .... ._. <br /> ... a ....; ' �...t. >... `f-,+...t- -` ....•,.......,�.........y...,,,..a....7.,,,.i ti �,.�.,.�...,. .,..�......,' <br /> •1- 1- -'L+•-V�^_. .._.!»....f... ..«...-. —--2.....«........_._....'"�',•._ .._ .-:.l._.. _rte..._...I € 4. .,.a..{i'.er-a,..'„"-:_.;_ ---1::-., _ <br /> _ _•. .. ... o ;...... - --•- -._.-a .#i a, .._. ..ie- l _ ...L_ �a1_LE`. ,�, <br /> • i i <br /> • <br /> - a...............�F........ ..,..........- : • -------t-----4---- -1,2-r. no".: --r— wc.^..''''4 " < ._.e.....,....... 1.1" ,4 <br /> Scale: 7^ �— „..tee � ..:_._..__ ._ �._..-._.._..` _ _ <br /> _ Drawn By: \ <br /> _ <br /> I certify that-the above information is ccutatejo the best ofppy knowledge. <br /> Applicant(Please Print) ./information <br /> �O' ic..e.d yG' phone...5-03 769-4a SG4. <br /> Mailing Address: - .. i. 2 i, :: �� 4 ,„_,_ 3Q2--• <br /> Applicant's Signature: • <br /> /771.",,,..,--4 ,......--. Date: l/z•-4(r6 <br /> FOR OFFIcE"oc ONLY <br /> PLANNING: Date: <br /> PUBLIC WORKS:• • Date: ' <br /> BUILDING INSPECTION: Date: <br /> IS-too ' <br /> A/ . <br />