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STATE OF ORI~GON <br />DEPARTMENT OF ENATIRONMENTAI, QUALITY <br /> <br />REPORT OF EVALUATION FOR ONE LOT <br /> ON-SITE SEWAGE SYSTEMS <br /> <br />The Entire Property [] Has <br /> <br />For ¢)ftlce Use Only <br /> <br /> Been Evaluated <br />[~Has Not <br /> <br />PLOT PLAN OF APPROVABLE AREA: <br /> <br /> / <br /> <br />/ <br /> <br />Any alteratmn of in the area approved for the on-site system or replacement area may' vmd this <br />approw~l <br />This approval m given on the basis that the lot or parcel descril~ed above will not be further partitioned or subdivided and <br />that conditions on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a <br />permit in accordance with ORS,, 454,,605 through 454,,755 and Administrative Rules of the Environmental Quality <br />Commission Any such subdivision, partitioning or alteration may void this report <br />The site has been found statable for installation of the £ollowipg kinds of on-site sewage disposal systems, with the <br /> <br />WARNING: This document is a technical report for on-site sewage disposal only. It may be converted tea permit only <br /> if, at the time of application, the parcel has been found to be compatible with applicable LCDC- <br /> acknowledged local comprehensive land use plans and implementing measures or the Statewidc Planning <br /> Goals. The Statement of Compatibility may be made on the attached form or its eqmvalent. Authorized <br /> Agent approval is required before a construction permit can be issued. <br />Tlats report h~ valid ~}~1 an. on-site sewage system is installed pursuant t~) a construction permit obtained frem <br />t [~_'~ Ca-It x~ ~OAT.,_ ~-p_,. ~(~ x__, or until earlier cancellation, pursuant to Commission rules, with written notice <br />thereof ~gthe Departmedt of Environmental Quality to the owners according to Department records or the Count~ tax <br />records IS]~ct t9 ~ fo~om~g, this report runs with the land and will autOmatically benefit subsequent owners <br /> <br /> <br />