Laserfiche WebLink
074,75bk?al <br /> RECEIVED <br /> MARION COUNTY PUBLIC WORKS <br /> BUILDING INSPECIION DIVISION FEB 072024 <br /> 5155 Merton Rd NE <br /> Salem OR 97305 <br /> (503)588-5147 Fax(503)5804948 <br /> httpdhrww.co.marion.or.us/PW/BuildingInspection <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> I., John B Leamons Jr. ,have authorized <br /> • (Propaty Owner/Print Name) <br /> Josh Hansen(Oregon Sewer&Drain LLC) 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 /> 21131 Bridge Creek ROSE Sihrerton,OR 97381 <br /> Propaty Situs or Street Address <br /> And&nailed in the records of MARION County as: <br /> Legal Description 5.85 acres,lot 13 Silver Summit Tax Lot 1/(s)081E01A000400 <br /> PROPERTY OWNER: <br /> • <br /> •Printed Narap. John S.Leamons Jr <br /> S%/laze= Dare: February 7,2024 <br /> Address: 211 B ge Creek RD SE phi=5034300-1249 <br /> City,State,Zip SivertOn,Oregon 97381 Fax: <br /> ,FoaraitAddress Kukumup.billeagmalloom <br /> AUTHORIZED REPRESENTATIVE: <br /> ,Printed Name: Josh Hansen <br /> company' Name: Oregon : LLCL - L <br /> Signatete: Date: - - <br /> Address: PO Bo 282 Phone: 503-874-9414 <br /> City,State,Zip Sitverton,OR 97381 Fax: <br /> E-mail Address josh@oregonsewer.com <br /> DEQ License# 38968 CCB# 201683 <br /> Auth to APOYibt <br /> '..MCS-07.RSV MO <br /> SEPTIC • 4 <br />