Laserfiche WebLink
Marion County <br /> <br /> OREGON <br />COMMUNITY D~iv'E/OPMENT <br />[DEPARTMENT <br /> <br />SEPTIC S,~STEM CERTIFICATION <br /> <br />PROPERTY OWNER-* <br /> <br />SITE ADDRESS: <br /> <br />SITE NUMBER: <br /> <br />I , hereby, certify that the attached site plan i~ an accurate <br />representation of the conditions on the above described property, <br />and that any proposed structure/property division, meets all of <br />the minimum setback requirements from the existing septic system, <br />and the future septic system replacement area. <br /> <br />I further certify that I have, to the best of my abilities, <br />thoroughly inspected the septic system and found no evidence of <br />any failure. The system appears to be functioning in a satisfac- <br />tory manner at t~is time. <br /> <br />(p~rty owned/authorized agent) <br /> <br />NAME (please print) <br /> <br />MAILING ADDRESS: <br /> <br />MC15-$38 <br />~EV 3/93 <br /> <br />t]UI LDING INS` <br /> <br /> <br />