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Marion C unty <br /> <br /> OREGON <br />COMMUNITY DEVELOPMENT <br />DEPARTMENT <br /> <br />REI]V£1I <br /> <br />I~iilOIJ COUNTY <br />IlUlLDINll IliSPEIJTION <br /> <br />PROPERTY OWNER: <br />BZTE NUI~ER: <br /> <br />SEPTIC SYSTEM CERTIFZCATION <br /> <br />I , hereby, certify that the attached site plan is 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 this time. <br /> <br />SIGNATURE: <br /> <br />NAME (please print) <br />HAILING ADDRESS: <br /> <br /> DATE: <br />(prSpe~zy ~w~er/authorized agent) <br /> <br />06.- 7 <br /> <br />MC15-S38 <br />REV 3/93 <br /> <br /> <br />