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MARION COUNTY PUBLIC WORKS MARION <br /> BUILDING INSPECTION DIVISION SUlfpin„ ''; <br /> as <br /> -- =,_'6 5155 Silverton Rd NE �' IN$''-0"RJfp <br /> Salem 97305 <br /> (503)5883Fax Fe:(303)588-7948 NOV 0/ 2012help://www.co.marlon,or.us/PWmufdinglnapection <br /> NOTICE AUTHORIZING REPRESENTATIVE <br /> United State of America,US Army Corps of Engineers Portland District <br /> I,Fnriot e(ndinez. Real Estate Contracting Officer ,have authorized Owner/Print Name) <br /> A-AccoCe\cLiot ',tic le rv;caZ 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 propetty <br /> described below in accordance with OAR chapter 340,division 071. <br /> PROPERTY IDENTIFICATIONI <br /> //IInLv, nsL. (a//eehpa, 9/0 /24-fl S4S./'a,... /40 <br /> Property Situs or Sheet Address y <br /> And described in the records of MARION County as: Parcel of land located in the NE%of the SE 1/4; <br /> Legal Description and the SEM of the NE X of Sec 30,T9S.MELot 8(s) Map#094E2900600 <br /> Parcel Lontains b.bb+/-Acres <br /> PROPERTY OWNER; <br /> United State of America, US Army Corps of Engineers Portland District <br /> Printed Name: EAr"ioue Godin/ez. Bial Estate Contracting Officer /- <br /> Signature: ihth p�q �'11-9�` Date:P 9 l-rWL7(2 <br /> Address: 't939 norA ,Seib 4/ 7a htDY Phone: <br /> City.State,Zip eaf s Ale 9 73 90. Fax: <br /> E-mail Address Enrique.godinez@usace.army.mil <br /> AUTHORIZED REP' c ENTATIVE;T <br /> Printed Name: Biel ` .4 s <br /> Company Name: Pr Accofkodole. s`-Y"c,_ SQ.cU,ce_, <br /> Signature: .- --..-,651- Date: //-I —/y <br /> Address: 2:1/41, 2i0X 1130 Phone: 608.(oRA• 1921 <br /> City,State,Zip ().\,1Sdn0iIle_ a 910170 Fax: 563•5 'b.0779 <br /> E-mail Address owtcer tinkle SzLivtle Se,nl;cc., <br /> DEQ License it 37118 'RI $V1 CCB# 158a44, <br /> G;VGRMB'SBPM1s-01 AWE leAppyda -- <br /> MC&er Rev 03/10 <br /> SePnC I <br />