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09/25/199B 14:26 5036362549 PARKWAY VET HOSPITAL PAGE 01 <br /> <br /> ........ '~, Mm'ion County Buil&i=g Inspecti n <br /> ~ YIO~' ~0 ~* Sa~m, O~gon 97305-1398 <br /> <br />PROPERTY OWNER: <br /> <br />SEPTIC SYSTEM CERTWICATION <br /> <br />SITE ADDRESS: <br /> <br />ACTIVITY NUMBER: <br /> <br />I certify that I have personally investigated the existing .septic system on the above pr <br />have identified th~ exact location of all pa~s of thc septic system, including the s <br />distribution box or ~rop boxes, draim~eld linos and future seplic system replacemenl <br />attachext site plan is an accurate representation of the location of the septic system am <br />structure(s) on the property, and the proposed development meets all minimum setbl~ <br />ments from the existing septic system, and the future septic system replacement area. <br /> <br />I further certify that I have, to the best of my abilities, thoroughly inspected the septic s <br />found no evidence of any failure. Thc system appea~ to be functioning in a satist'acto <br />at thi~ time, <br /> <br />SIGNATURE: <br /> <br />Name (ple~e print): <br /> <br />Company Name: <br /> <br />Mailing Address: <br /> <br />(licensed septio imlallm', :mpfic comultant~own~r~r~ <br /> <br />Date: <br /> <br />~'y and <br />ptic tank, <br />area. The <br />proposed <br />require- <br /> <br />3tern and <br /> <br /> <br />