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DocuSign Envelope ID:017DEA76 74FB-4B45-A2BE-914AF5791FBE <br /> 1 � <br /> t MARION COUNTY PUBLIC WORKS <br /> ‘i140 '' BUILDING INSPECTION DIVISION ni <br /> • 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503)588-5147 Fax(503)588-7948 MDONCOUNTY <br /> N <br /> BU INSPECTION <br /> www.co.marion.or.us/PW/BuildingInsneetion <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> Ferschweiler Intermodal, LLC ,have authorized <br /> (Property Owner/Print Name) <br /> AKS Engineering and Forestry/Tyler Roth 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 /> Property Situs or Street Address <br /> And described in the records of MARION County as: <br /> Legal Description Sec 15, T5S, R2W, W.M. Tax Lot#(s) 400 <br /> PROPERTY OWNER: <br /> Printed Name: erschweil l termodal, LLC <br /> Signature: Date: 06-05-2023 <br /> Address: 6800 Brun Road NE Phone: <br /> City, State,Zip oodburn, Oregon 97071 Fax: <br /> E-mail Address <br /> AUTHORIZED REPRESENTATIVE: <br /> Printed Name: Tyler Roth <br /> Company Name:_AKS Engineering and Forestry <br /> Signature: Date: 06-05-2023 <br /> Address: 3700 River Road N., Suite 1 Phone: 503-400-6028 <br /> City, State,Zip_ Keizer, Or 97303 Fax: <br /> E-mail Address_ rotht©aks-eng.com <br /> DEQ License# CCB# <br /> G:\FORMS\SEPTIC\Application Packets1S-07 Auth to Apply.doc <br /> MCS-07 Rev 03/10 <br /> SEPTIC 4 <br />