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� <br /> ���� ',IP <br /> MARION COUNTY PUBLIC WORKS ECENED <br /> 011#4k <br /> � <br /> � ���� BUILDING INSPECTION.DIVISION <br /> 5155 Silverton Rd NE <br /> Salem.OR 97305 MAY 101019 Li <br /> TY <br /> (503)588-5147 Fax(503)588-7948 MARION COON, <br /> http://www.co.marion.or.us/PW/BuildingInspection ILDING����ECTICN <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> I, <br /> Mark Krautmann of Mark & Jolly LLC ,have authorized <br /> (Property Owner/Print Name) <br /> Anthony Odenthal to act as my agent in performing the <br /> (Authorized Representative/Print Name) <br /> activities necessary to obtain site evaluations,permits,and other onsite wastewater treatment program <br /> services <br /> describedvicprovided by the Department of Environmental Quality or County-Agent on the property <br /> below in accordance with OAR chapter 340,division 07L, <br /> PROPERTY IDENTIFICATION:. <br /> Property Situs or Street A dress <br /> And described in the records of MARION County as: <br /> Legal Description. ACRES 27.92 Tax Lot#(s) 092W11 01400 <br /> PROPERTY OWNER: <br /> Printed Name: Mark Krautmann of Mark & Jolly LLC <br /> Signature: 74144/e___ lLrc c7i.•a K,�/" Date: 5/10/2019 <br /> Address:. 4194 71st AVE SE Phone:503-585-9835 <br /> City, State,Zip Salem, OR 97317 Fax: 503-371-9688 <br /> E-mail Address sales@heritageseedlings.com <br /> AUTHORIZED REPRESENTATIVE: <br /> Printed Name: Anthony Odenthal <br /> Company Name: Heritage Seedlings & Liners Inc. <br /> Signature: Date: <br /> 5/10/2019 <br /> Address: 4194 71st AVE SE Phone: 503-585-9835 <br /> City, State,Zip Salem, OR 97317 Fax: 503-371-9688 <br /> E-mail Address aodenthal@heritageseedlings.com <br /> DEQ License# CCB# <br /> G:IFORMSISEPTICIS-07 Auth to Apply.doc <br /> MCS-07 Rev 03/10 <br /> SEPTIC 4 <br />