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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 SYSTEMS <br />~x4~//4D~_~a~ (Technical Report -- Not a Permit) <br /> <br />For Office Use Onlk <br /> <br />The Entire Property C3 Has <br /> Been Evaluated <br /> [~_ Has Not <br /> <br />PLOT PLAN OF APPROVABLE AREA: <br /> <br /> ' '%-v x~ ~'-~ .... ~'?12~D r ,, , <br /> <br /> . <br />Any alteration of the natural conditions in the area approved for the on-sf~ sysmm or replacement area may void this <br />approval, <br />This approval is given on the basis that the lot or parcel described a~ve will not ~ fu~her pa~itioned or su~ivided and <br />that g~nditious on subject or ad jaunt pmpe~ies have not ~en altered in any manner which would prohibit issuance of a <br />~rmit in ac~rdance with ORS,, 454605 through 454.755 and Administrative Rules of the Envirenmental Quality <br />Commission, Any such suMivision, pa~itioning or almration ~ay void this ~po~. <br /> <br />The site has ~en found suitable for i~tallation of the followi~ kinds of on-site sewage disposal sysmms, with the <br />limitations and~dditioml ~~indicated <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 be made on the attached form or its equivalent, Authorized <br /> Agent approval is required before a construction permit can be issued, <br />~,s report ~,/va~t~l an on-site sewage system is installed pursuant to a construction permit obtained from <br />/I'IOA~,Iz°XK-__CiP~ _~~k-~ or until earlier cancellation, pursuant to Commission rules, with written notice <br />thereof by the Depa~rhent of Ehvironmental Quality to the owners according to Department records or the County tax <br />records Su~')e~ort runs with the land and will automatically benefit subsequent owners <br /> <br /> <br />