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STATE OF OREGON <br /> <br /> DEPARTMI~NT OF ENVIRONMENTAL QUALITY <br /> <br /> REPORT OF EVALUATION FOR ONE LOT <br /> <br />............ "_ ..... <br /> <br />The Entire Property ~ <br /> Been Evaluated <br /> <br />PLOT PLAN OF APPIIOVABLE AREA: <br /> <br />For Office Use Only <br /> <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 paroel 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 />limitations and..additiocsll requiremerdts 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 lJ2DC- <br /> acknowledged local comprehensive land use plans and implementing measures or the Statewide Planning <br /> £h)als. 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 />d~]~]an. [~x-site sewage system is installed pursuant tea construation permit obtained frem <br />t~, or until earlier cancellation, pursuant to Commission rules, with w~ritten notice <br />theree£ by the Departme. n~ bi Envirbnmental Quality to the owners according ~o Department records or the County tax <br /> <br /> <br />