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1414 r <br /> MARION COUNTY PUBLIC WORKS <br /> BUILDING INSPECTION DIVISION <br /> 555 Court St. NE Room 2260/PO Box 14500 <br /> Salem OR 97309-5036 <br /> (503)588-5147 Fax(503) 588-7948 <br /> http://publicworks.co.marion.or.us/building/ <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> 1, Troy Kuenzi, President of Pratum Coop ,have authorized <br /> (Property Owner/Print Name) <br /> Zollinger Excavating PIC_ 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 provided by the Department of Environmental Quality or County Agent on the property <br /> described below in accordance with OAR chapter 340, division 071. <br /> PROPERTY IDENTIFICATION: <br /> Pratum Co-op 8955 Sunnyview Rd., Salem, OR <br /> Property Sims or Street Address <br /> And described in the records of MARION County as: <br /> Legal Description 072W130002 Tax Lot#(s)100A2 <br /> PROPERTY OWNER: <br /> Printed Name: Troy Kuenzi, President <br /> f/ t <br /> Signature: 03/07/2022 <br /> z Date: <br /> Address: 8955 Sunnyview Rd. Phone:503.364.3353 <br /> City, State,Zip Salem, OR Fax: <br /> E-mail Address Troy@mtviewseeds.com <br /> AUTHORIZED REPRESENTATIVE: <br /> Printed Name: ( i p Gar <br /> Company Name: GG i i tEkc fkl( <br /> Sigma +`$ .' Date: ...� .3/0 <br /> Address: 77/ f F , 2 ( ) Phone: /s�3 T?/- <br /> City, State,Zip illlNilk//ltZE 777ZS Fax: <br /> E-mail Address `tfri x.G'o� <br /> DEQ License# S(� 7Y� CCB # YZo.37 <br /> G:\FORMS\SEPTIC\S-07 Auth to Apply.doc <br /> MCS-07 Rev 03/07 <br /> SEPTIC 4 <br />