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STATE OF OREGON <br /> <br />DEPAI~TMENT OF ENVIRONMENTAl, QUALITY <br /> <br /> REPORT OF EVALUATION FOR ONE LOT <br /> ON-SITE SEWAGE SYSTEMS <br /> <br />· I <br /> <br />.......... (~uhdivi~ion Name) (Lot No.) (Block No.) <br /> <br />The Entire Property [~Has <br /> j [2 _H_as_ Not Been Evaluated <br />P~-~ PLAN OF~APPROVABLE AREA: <br /> <br />For Office Use Only <br /> <br />_ _ __ P'PP~e v ..e?_ _ J--_ Lv_2n//,J.~'~_i <br />Any alteration of the natural conditions in the area approved for the on-site system or replacement area may void this~' <br />approval. <br />This approval is given on the basis that the lot or parcel described above will not be further partitioned or subdivided and <br />that conditions on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a <br />permit in accordance with O.R.S. 454.605 through 454.755 and Administrative Rules of the Environmental Quality <br />Commission. Any such subdivision, partitioning or alteration may void this report- <br /> <br />The site has been found suitable for installation of the following kinds of on-site sewage disposal systems, with the <br />limitation~-~a~d additional requirements indicated: , <br /> <br />WARNING: This document is a technical report for on-site sewage disposal only. It may be converted to a permit only <br /> if, at the time of application, the parcel has been found to be compatible with applicable LCDC- <br /> acknowledged local comprehensive land use plans and implementing measures or the Statewide Planning <br /> Goals. The Statement of Compatibility may be made on the attached form or its equivalent. Authorized <br /> Agent approval is required before a construction permit can be issued. <br />This r.epert, is ;~alidl un~ti,k ~m on-site sewage system is installed pursuant to a construction permit obtained from <br />~ (~. ~. ~1~, or until earlier cancellation, pursuant to Commission rules, with written notice <br />thereof b' ' y the Dep~artmfe~nt of l~nvire~nmental Quality to the owners according to Department records or the County tax <br />re~ds. Subject ~ j~he fo/~going, this report runs wi~,~he land and will automatically benefit subsequent owners. <br /> <br /> <br />