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STATE OF OREGON <br />DEPARTMENT OF EN'v'IRONMENTAL QUALITY <br /> <br />REPORT OF EVALUATION FOR ONE LOT <br /> ON-~IITE SEWAGE [IYSTEMS <br /> <br />The Entire Property ~ Has <br /> <br />Been Evaluated <br /> <br />For Office Use Only <br /> <br />PLOT PLAN OF APPROVABLE AREA: <br /> <br />Any alteration of the natural conditions in the area approved for the on-site system or replacement area may void this <br />approval. <br />This approval is given on the basis that the lot or parcel described 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 O.R.S. 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 /> <br />The site has been found suitable for installation of the following kinds of on-site sewage disposal systems, with the <br />limit t~s and.~idition.al requi~_me~u~ indica~te~l~ <br /> <br />WARNING: This document is a technical report for on-site sewage disposal only. It may be converted to a 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 Statewide Planning <br /> Goals. The Statement of Compatibility may bo made on the attached form or its equivalent. Authorized <br /> Agent approval is required before a construction permit can be issued. <br />This ~pert,:is v~lid ~i]q an An-site sewage system is installed pursuant to a construction permit obtained from <br />...... J~ ~-~ · ~ ~ , or until earlier cancellation, pursuant to Commission rules, with written notice <br />thereof by the Department/of Environmental Quality to the owners according to Department records or the County tax <br />rec°~,~~2~this report runs w~_~he land and will automatically benefit subsequent °wners'_~r~ <br />DEQ-WQ-XL tt8 <br />3/81 <br /> <br /> <br />