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Last modified
5/23/2019 8:34:37 AM
Creation date
5/22/2019 2:56:05 PM
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Permits
Permit Address
10067 SIEGMUND RD SE
Permit City
STAYTON
Permit Number
555-19-002718-PRMT
Parcel Number
091E10 00200
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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Septic Permit 555-19-002718-PRMT Page 3 of 3 <br /> tate.G rt cate Issued 6/22/2019 ,f M *F t i P ,V 3 r r F z <br /> Work Description h71AJ REPAIRIA 1Tk'I�HARDSI•ilP 4.BDRM MAII ROME 33RDRM HARDSHIP F ,W <br /> Installation of this onsite wastewater treatment system has been determined to comply with the applicable requirements in <br /> Oregon Administrative Rules Chapter 340, Divisions 071 and 073 and the Conditions of Approval above. <br /> 1. In accordance with.Oregon Revised Statute 454,665,this Certificate of Satisfactory Completion is issued as evidence of <br /> satisfactory completion of an onsite wastewater treatment system at the location identified above. <br /> 2. Issuance of this Certificate does not constitute a warranty or guarantee that this onsite wastewater treatment system will <br /> function indefinitely without failure. Conditions imposed as permit requirements continue for the life of the system. <br /> 3.The area of the initial and the identified replacement area must not be subjected to activity that is likely to adversely <br /> affect the soil or the functioning of the system. Such activities may include, but are not limited to,vehicular traffic, livestock, <br /> covering the area with asphalt or concrete,filling,cutting, or other soil modification activities. <br /> 4.This onsite wastewater treatment system that be connected to the facility referenced herein within 5 years of the <br /> issuance of this Certificate of Satisfactory Completion(CSC)or rules for authorization notices,alteration permits,or <br /> construction-installation permits as outlined in OAR 340-071-0160, 340-071-0205, or 340-071-0210 apply, including <br /> payment of an additional fee. <br /> 5.This system must operate in compliance with OAR Chapter 340, Division 071 and must not create a public health hazard <br /> or pollute public waters. <br /> 6. Unless otherwise required by the agent,the system installer must backfill(cover)this system within 10 days after the <br /> issuance of this Certificate of Satisfactory Completion. <br /> : Gettttc t$g Sat�sf ctary G97fpfpi <br /> System Inspection: Yes Operation of Law-7 Days Notice: No Pre-Cover Inspection Waived Per 340-071: No <br /> Comments: N/A <br /> �� <br /> Inspector Inspection Inspection Date Inspection Result <br /> Matthew Puntney 7999 Final Septic 05/13/2019 Approved <br /> Matthew Puntney 7020 Pre-cover 05/09/2019 Approved <br /> Matthew Puntney 7100 Septic Tank 05/09/2019 Approved <br /> Matthew Puntney Onsite Inspector <br /> CALL BEFORE YOU DIG...ITS THE LAW <br /> ATTENTION:Oregon law requires you to follow,rules adopted by the Oregon Utility Notification Center. Those rules are set forth by Oregon Administration Rules. You may obtain copies <br /> of the rules by calling the center.(Note:The telephone number for the Oregon Utility Notification Center is 1-800-332-2344.) <br /> 5/22/19:11:10:50AM Page 3 of 3 ONS_OnsiteCSCjr <br />
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