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Marion County <br /> <br /> OREGON <br />COMMUNITY DEVELOPMENT <br />DEPARTMENT <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />PROPERTY OWNER: <br /> <br />SITE ADDRESS <br /> <br />SITE _, <br /> <br />I, hereby, certify that the attached site plan is an accurate <br />representation of the conditions on my property, ahd that the <br />proposed structure meets all minimum setback requirements from <br />the existing septic system, and the future septic system replace- <br />ment area. <br /> <br />I further certify that I have, to the best of <br />thoroughly inspected the septio system and found <br />any failure. The system appears to be functioning <br />tory manner at this time. <br /> <br /> ~prop~rty owner or authorized aqent) <br /> <br />my abilities, <br />no evidence of <br />in a satisfac- <br /> <br />MC15-$38 <br />Rev 2/93 <br /> <br />24 Hour Code-A-Phone 588-7904 <br /> <br />(503) 588-5347 Senator 8uildlng <br />F^x(503) 588-7948 220HighSt. N[oSalrm, OR 97301.3670 <br /> <br /> <br />