Laserfiche WebLink
ar on, ,count! <br /> <br /> OREGON <br />COMMUNITY DEVELOPMENT <br />DEPAI~TMENT <br /> <br /> RECEIVB' <br /> <br />~[~l~'j COUNTY <br />BU[LDfNG INSPECT]ON <br /> <br /> PROPERTY OWNER: <br /> <br />, $~TE ADDRESS: <br /> SITE NUMBER: <br /> <br />PERMIT NUMBER: <br /> <br />I, hereby, certify that the attached site plan is an accurate <br />representation of the conditions on my property, and that the <br />proposed sCructure m~ets all minimum setback requirements from <br />the existing septic system, and th~ future septic system replace- <br />ment area. <br /> <br />I further certify that I have, to the best of my abilities, <br />thoroughly inspected the septic system and found no evidence of <br />any failure. The ~ystem appears to be functioning in a satisfac- <br />tory manner at this time. <br /> <br />(PrOPert~ 6wner or autho~rizea <br /> <br />Mailing Address: <br /> <br />MC15-83 8 <br />Rev :ZJg~ <br /> <br /> <br />