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STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY REPORT OF EVALUATION FOR ONE LOT K~q&~c~'>:~ Dz gq ~1 t~~ o~-srr~; S~WAOS SYSTE~S ~ ~ hmcal ~rt -- Not a Permit) The Entire Property--~14as~ ~ Flas Not Been Evaluated PLOT PLAN OF APPROVABLE AREA: Nil: '-~'- ~ / ~ ~---- ~ //~:~/P~ ~' r I Any alteration of [he natural conditir3n~ iB gh~ area approved ~or the on-site sysg~m or rcpla~moBt area may void approval This approval is given on the basic that the lot or parcel described a~ve will ~ot be further pa~itioned or su}~ivided a~d that conditions on ~ubject or ad jaunt propo~ies have not been algered in any manner which would prohibit issuance o~ a permig in accordance w~th OR8 454,~05 through 454,,7~5 and Administrative Rules of ghe Envir~>nme~gal ~uality Commission Any ~uch subdivision, pa~t~oning or alteragion may void ~h~s report. Tho uite has ~en found suih~ble for inshallat~on of the followi~ kinds of on-sige sewage d~sposal syatems, wi~h WARNING: This document is a technical report for on-site sewage disposal only it may be convertod to a permit only if, at the time of application, the parcel has been found to be compatible with applicable LCDC- acknowledged local comprehensive land use plans and implementing measures or the Statewide Planning Goals. The Statement of Compatibility may be made on the attached form or its equivalcn~ Authorized Agent approval is required before a Construction permit can be issued. Ti~as r~port is,..vahd~ur~l dh ,.on-site sewage system ic installed pursuant to a construction permit obtained from ~t~DA~-~.'~--CP, ~k/~ ~a~7 , or until earlier cancellation, pursuant t~ Commission rules, with written notice thereof by the Departmerk of En~wronmental Quality to the owners according to Department records or the County tax recorr/~Subject ;p ~I~ ~regoing, this report runs with,yale land and will automatically benefit subsequent owners.