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Marion County <br /> <br /> OREGON <br />COMM UNI'FY DEVELOPMENT <br />DEPARTMENT <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />PROPERTY OWNER: <br /> <br />SITE ADDRESS: <br /> <br />SITE NUMBER: <br /> <br />I , hereby, certify that the attached site plan is an accurate <br />representation of the conditions on the above described property, <br />and that any proposed'structure/property division, meets all of <br />the minimum setback reqq/irements from the existing septic system, <br />and the future septic system replacement 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 system aPPears to be functioning in a satisfac- <br />tory manner at this time. <br /> <br /> ~(property~r~r/authorized agent) <br />NAME (please print) : ~,~ ~ ~a$~O k~AG~ <br /> <br />MAILING ADDRESS~ <br /> <br />MClS-S38 <br />REV 3/93 <br /> <br /> <br />