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D0oU3i:„_..'::.EnvelOOd ID:EFD7AC6C,66874.. F&SD94-80130.F,A91g.?13D, 1Z -- 0j cie <br /> ..: . :• . <br /> MARION CsroaP97736L:CW ORKS <br /> 1:31;1111,INOINSPECTON:DillfSION. <br /> (503)$861$;:7117:::11(1:137.88.494$; <br /> littp.iiiw**-,co.mariort.ok.us/PW/DiatiliglusPectitim .: <br /> . <br /> . . <br /> ---,--st•.-__-c-7,_ <br /> ,„„,.........„,.. ,:.,, ...„.„...., <br /> NOTICKAUTHORIZING.REPRESE.NTATIVE. <br /> . ' . <br /> I, Aleksandr V. Kravets ,have atititodzed <br /> . <br /> (Property.Owner/Print,Name) <br /> Ameri can on Site to-act.as myiagertin perfor.mha'g the <br /> . . . . . <br /> (AuthorizedRepresentativelPrint Name). <br /> activities necessary to obtain site evaluation ,permits, and Other onsite wastewater treatment:program <br /> services proVided by the:DO.p&tfuOittofttpiiratpiolital Quality or County Agear on,the property <br /> described beloWin'acOordance with OAR*inter$.4Q.,:cli*ion"071, <br /> PROPERTY DJENTIFtCATION: <br /> 17.80 soak sOories Ferry.. .1.0.04 yoociblen, oregon„ .57071 <br /> Property Situs..or Si <br /> And described in the records OtIVIARIONCatinty.as: <br /> Legal Description:051W19g Tex Lot,40 00900 .. . . <br /> PROPERTY OVVNER: <br /> Printed k.:..,..,-.41M.sandr V. Kravets. <br /> ... . . ... . . <br />, Sipe ;libx K. . , . Date:-.. :5120/2021 .. <br /> Address:antrg91fRins Ferry Rd... Phone:.:508-611- <br /> City;State..,Zip Woodburn Oregon,. 97071 Fax: <br /> Feinall Address giexl.c.wch s@amal 1 ..corn <br /> AU'rEfORIZEDREPRESENTATIVE:: <br /> ;., <br /> Prihted Namet,513A.ASI AjbhhSbn: . <br /> r Company Name:: -4ri.:c4n..0h Sli,te. <br /> Signature: . .: 11 IVA.1..)1,./Ns_i/r) <br /> Date: czi19.01.c.9.4a <br /> . . . . <br /> Address:.31881 s Hwy.213 plionet..503:-.8.2.91 7600 <br /> City,State,Zip mol al la,. or :97038 Fax: 5038297-776: <br /> -rnail Address -aOssientit@yah:oo,com <br /> DEQ,License#38346 •CCB#' 15.8543 : <br /> 0.:7•01,0441.5EFTIOW:Aut)ip Apply43:0 <br /> .MOS.=.07,Req OSPIQ 1 <br /> I sePpc 4 <br />