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STATE OF OREGON <br /> <br />DEPARTMENT OF ENVIRONMENTAl., QUALITY <br /> <br /> REPORT OF EVALUATION FOR ONE LOT <br /> ON-SITE SEWAGE SYSTEM~ <br /> <br />The Entire Property ~ Has <br /> Been Evaluated <br /> ~ Has Not <br /> <br />PLOT PLAN OF APPROVABLE AREA: <br /> <br />Any alteratmn of the natural conditions in the area approved for the on-site system or replacement area may ¥oid this <br />approval,, <br />This approval is given on the basis that the lot or parcel described above will not be further partitioned or snbdivided and <br />that conditmns on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a <br />permit m accordaoce w~th O R,S 454605 through 454755 and Admimstrative Rules of the Environmental Quahty <br />Commission Any such subdivision, partitioning or alteration may void this report <br /> <br />The site has been found suitahle for installation of the following kinds of on-site sewage disposal systems, with the <br />hm~tatigz~s and additmr~al requt~ements indicaLed:: ,~ /D <br /> <br />WARNING: This document is a technical report for on-rote sewage dmposal only It may be c:onverted to a permxt 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 S~tcwidc Planning <br /> Goals The Statement of Compatibility may ~ made on the attached form or its equivalent Authorized <br /> Agent approval is required ~fore a construction permit can ~ issued <br />T~f~repo~ ~va~il a~ on-s~te sewage system ~s installed pm'suant to a construction permit obtained from <br />~__~- ~_~ , or until earlier can~llation, pursuant ~ Commission mice, with writ~n notice <br />thereof by the Depa~m~nt of Enviromnental Qaality to ~he owners according ~) Depa~ment records or the County tax <br />records~9t ~g(~this repo~ mas w~th the land and will automatically ~nefit subsequent owners <br /> <br /> ....... ,- <br /> <br /> <br />