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;40,1iik • <br /> '.MARION COUNTY PUBLIC WORKS <br /> BUILDING INSPECTION DIVISION <br /> 1 5155 Silverton'lid NE <br /> Salem OFt 97305• )\ <br /> (503)588-5141 Fax2(503)5884948 <br /> http://Wwvv.ce.marion.orais&W/Buildinginspeetion <br /> .\) <br /> NOTICE AVTHORIZING REPRESENTATIV <br /> Richarda "Cara"Tapken have authorized <br /> çProperty,Owner/Print Name) <br /> to act as my at•nt in performing the <br /> (Apthorizeciaepresentative I P int Name) <br /> activities necessary to obtain site evaluations, permits,and other onsite w.. tewater treatment program <br /> services provided :b) the Department of Environmental Quality or etmty Agent on the property <br /> deScribed,below in accordance with-OAR chapter 340,division.071. <br /> PROPERTY IDENTIFICATION: <br /> H11297 Pioneer Rd SE Lyons, OR 97358 <br /> Property Situs:or Stree ddress <br /> Described in the records of MARIONCourity as: <br /> Legal Description Taylors Grove Lot 2 Block 1 Ta,,c•Lot#0. 092E16BC00500 <br /> Subdivision;Lot and Blo• <br /> - PROPERTY OWNER <br /> Printed Name: Richarda Tapken Co ty Clerk h.s not yet recorded new deed. Sale was 11/1/2023 <br /> Signature: ARicharda Tapken <br /> PPravarrar, 4, Date 1/8/2024 <br /> Address: 1021 Browns Chapel -a Phone,: 971-772-9570 <br /> City, State,Zip Parrottsville, T. 37843 Fax: <br /> ,X-mail Address carata•ke mail.com <br /> Effective 1/31/24 po bo 674 Lyons, OR 97358 <br /> AirritOmzER REP D4 ISENTATIVE: <br /> Printed Name: A - . . . <br /> Company Narn'. * ; <br /> Signature: - 0 Date:. 01 /06 <br /> r <br /> Address:' -SI • ° Photte7 <br /> City, :te,Zip ;Atk GV1/41, 7k --0036t1 Fax: <br /> E- .il Address( ( on:Lemvyi <br /> • M6-6„2., ccw# 2.3G ON() <br /> GVORMS‘SEPTICIS-OTAUlli TO APPLYDOCX Rev 3/10,-3/}$ <br />