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COMMU NI'P( DEVELOPMENT <br />DEPARTMENT <br /> <br />Marion County Building Inspection <br />3150 Lancaster Dr NE - Suite C <br />Salem, Oregon 97305-1398 <br />PH# 588-5147 ~[~'(~ ~ ~[~) <br />FAX 5SS-794S JUN 1999 <br /> MARION ~'OUNTY <br /> BUILDING INSPECTION <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />PROPERTY OWNER: <br /> <br />SITE ADDRESS: <br /> <br />ACTIVITY NUMBER: <br /> <br />I certify that I have personally investigated the existing septic system on the above property and <br />have identified the exact location of all parts of the septic system, including ,the septic tank, <br />distribution box or drop boxes, dralnfield lines and future septic system replacement area~ The <br />attached site plan is an accurate representation of the location of the septic system and proposed <br />structure(s) on the property, and the proposed development meets all minimum setback require- <br />ments from the existing septic system, and the future septic system replacement area~ <br /> <br />I further certify that I bave, to the best of my abilities, thoroughly inspected the septic system and <br />found no evidence of any failure. The system appears to be functioning in a satisfactory manner <br />at this time. <br /> <br />SIGNATURE: <br /> <br />Name (please print): <br /> <br />Company Name: <br /> <br />Mailing Address: <br /> <br />(hce]lsed SeptiC miler, septic consultant or owner) <br /> <br /> / <br />Date: ~-/a - ~' 7 <br /> <br />MCl5-S38 <br />RI~V 6/98 <br /> <br /> <br />