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STATE OF OREGON <br /> <br />DEPARTMENT OF }~NVIRONrMENTAL QUALITY <br /> <br />REPORT OF EVALUATION FOR ONE LOT <br /> ON.SITE SEWAGE SYSTEMS <br /> <br />The Entire Property ~ Has <br /> 1~ Has Not <br /> <br />Been Evaluated <br /> <br />For Of[ice Use Only <br /> <br />PLOT PLAN OF APPROVABLE AREA: <br /> <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.$. 4,54.00,5 through 4§4.75§ 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 an0~dditi(trla] requirements indicated: <br /> <br />WARNING: This document is a technical report for on-site sewage dispesal only. It may be cenverted 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 />T~a report is/valid u~z~_n o~/site Sewage system is installed pursuant to a construction permit obtained from <br />! ~'_~/~._--~C~.,..~:~, or until earlier cancellation, pursuant to Commission rule~, with written notice <br />thereof. J~¥ tt~e Department (~ Envire~hmental Quality to the owners according to Department records or the County tax <br />recer~.,~k~j~ct to t~y~ [~re~oir)g~ this report runs with t~ land and will automatically benefit subsequent owners. <br /> <br /> <br />