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MARION COUNTY PUBLIC WORKS <br /> — <br /> tut BUILDLYG INSPECTION DIVISION• Ot <br /> 5 1 5 5 Silvertort RD NE <br /> I1ly0814" °a7°5-547 Fax503)588494 AUG 27 <br /> • //w .eo. aron.nr.us• m MARION COUNTY <br /> BUILDING INSPECTION <br /> SEPTIC SYSTEM CERTIFICATION for RECORD REVIEW <br /> PROPERTY OWNER: ThornAj <br /> SITEADDRESS: g fa)4' nell'eelN 0 g-s, <br /> DATE:: —SA" )2 cl.q <br /> C7.'73 0_5 <br /> FILE NUMBER: <br /> I certify that I have personally investigated the existing septic system on the above property and have <br /> identified the exact location of all parts of the septic system,including the septic tank,distribution box <br /> or dreg boxes, drainfleld lines and future septic system replacement.area.The attached site plan is an <br /> accurate representation of the location of the septic system and proposed structure(s) on the property, <br /> and the proposed development meets all minimum setback requirements from the existing septic <br /> system,and the future septic system replacement area. In addition if there isn't a septic system serving <br /> the Property,this document is to certify that a full investigation has been made to determine that the <br /> parcel is not being served by a septic system. <br /> I further certify that I have,to the best of my abilities,thoroughly inspected the septic system and Ibund <br /> no evidence,of any failure. The system appears to be functioning in a satisfactory manner at this time. <br /> SIGNATURE: szjjjepler—c4Q—en•-_,:_. <br /> (Property er or the Owner's Authorized Agent) <br /> Name(please print): 7-1-0m...5._s 7sohi1elfo-Ai <br /> Company Name: Tuff Shed <br /> Mailing Address: P-0- 9)03, s-PM8 <br /> Si 0:446 Oa -73115 <br /> Phone Number: 5 -. <br /> r1.3. 4-6 7- (4.) <br /> WIFORNISISEPTICS-38 RR CestificatiemnFinaLdw 555 key;9110.lit I <br />