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�� MARION COUNTY PUBLIC WORKS <br /> • <br /> �C�L �dL <br /> Mg <br /> ��I 1j��ii"'� BUILDING INSPECTION DIVISION iV) <br /> APR 29 <br /> ��%`�� �� 5155 Silverton Rd NE 20,9 < - <br /> Salem OR 97305 fV1ARl0� C®� <br /> R <br /> (503) 588-5147 Fax(503) 588-7948 <br /> BUILDING INSPECTION http://www.co.marion.onus/PWBuildingInspection ( a/—CPQ R�CTfOf� <br /> C� <br /> NOTICE AUTH;ORIZIING REPRESENTATIVE <br /> I, Eric Enright ,have authorized <br /> (Property Owner/Print Name) <br /> Josh Hansen ( Oregon Sewer & Drain LLC) to act as my agent in performing the <br /> (Authorized Representative/Print Name) <br /> activities necessary to obtain site evaluations,permits, and other onsite wastewater treatment program <br /> services provided by the Department of Environmental Quality or County Agent on the property <br /> described below in accordance with OAR chapter 340, division 071. <br /> PROPERTY IDENTIFICATION: <br /> 6 J <<.-td, eq- E 5,,Le( �� 't—rg 17 <br /> Property Situs or Street Address <br /> And described in the records of MARION County as: <br /> Legal Description 6422 Walina CT SE, Salem OR 97317 Tax Lot#(s)R59235 <br /> PROPERTY OWNER: <br /> Printed Name: Eric Enright <br /> Signature: (uc (' Date: 4/22/2019 <br /> Address: 6481 Walina CT SE Phone:541-912-4516 <br /> City, State, Zip Salem, OR, 97317 Fax: <br /> E-mail Address eric.t.enright@gmail.com <br /> AUTHORIZED REPRESENTATIVE: <br /> Printed Name: Josh Hansen <br /> Company Name: Oregy- - Ter & D e LLC <br /> Signature: ./ - ' Date: Lf-6Z1-('v <br /> Address: PO :ox 1 82 - Phone: 503-874-9414 <br /> City, State,Zip Silverton, OR 97381 Fax: <br /> E-mail Address josh@oregonsewer.com <br /> DEQ License# 38968 CCB# 201683 <br /> G:\FORMS\SEPTIC\S-07 Auth to Apply.doc <br /> MCS-07 Rev 03/10 <br /> SEPTIC 4 <br />