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DocuSign Envelope ID:1A2BDC41-FD98-412D-ACED-1693F5FD3FF0 <br /> MARION COUNTY PUBLIC WORKS <br /> BUILDING INSPECTION DIVISION <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503) 588-5147 Fax(503) 588-7948 <br /> http://www.co.marion.or.us/PW/BuildingInspection <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> I� Insurance Auto Auctions, Inc., an Illinois corporation ,have authorized <br /> (Property Owner/Print Name) <br /> Alain Rebeyrol to act as my agent in performing the <br /> (Authorized Representative/Print Name) <br /> activities necessary to obtain site evaluations,permits, and other onsite wastewater treatment program <br /> services provided by the Department of Environmental Quality or County Agent on the property <br /> described below in accordance with OAR chapter 340, division 071. <br /> PROPERTY IDENTIFICATION: <br /> 605 S Pacific,Woodburn, OR 97411 <br /> Property Situs or Street Address <br /> And described in the records of MARION County as: <br /> Legal Description 051W18D Tax Lot#(s) 000300, 000400. 000500, 000600 <br /> PROPERTY OWNER: <br /> Printed Name: Insurance Auto Auctions, Inc., by John W. Kett, Chief Executive Officer <br /> 000,S5amd q: <br /> Signature: [ittu&.kt Date: 11-22-22 <br /> F608805CFA27480_. <br /> Address: Two Westbrook Corporate Center, 10th Floor Phone:224-500-8633 <br /> City, State,Zip Westchester, IL 60154 Fax: <br /> E-mail Address rschlenker@iaai.com <br /> AUTHORIZED REPRESENTATIVE: <br /> Printed Name: ALAIN REBEYROL <br /> Company Name: COMPOSITE ARCHITECTURE, LLC <br /> Signature: Date: November 22, 2022 <br /> Address: 30 E BROADWAY, SUITE 151 Phone: 541-683-5762 <br /> City, State,Zip EUGENE, OR 97401 Fax: <br /> E-mail Address REBEYROL@COMPOSITEARCHITECTURE.NET <br /> DEQ LICCn9C if CCB ItOregon State Board of Architect License:ARI-5395- <br /> G:\FORMS\SEPTIC\S-07 Auth to Apply.doc <br /> MCS-07 Rev 03/10 <br /> SEPTIC 4 os <br />