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SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT
Clean Water Services File Number 20-001648
1. Jurisdiction: Washington County
2. Property Information(example: 15234AB01400) 3. Owner Information
Tax lot ID(s): 2S102DC00800 Name: Donald Lally
Company:
Address: 8870 sw omara st
OR Site Address: 8870 sw omara st City,State,Zip: Tigard, Oregon, 97223
City, State,Zip:Tigard, Oregon, 97223 Phone/fax: 503-970-9943
Nearest cross street: EDGEWOOD Email: raptordon69@comcast.net
4. Development Activity(check all that apply) 4. Applicant Information
® Addition to single family residence(rooms,deck,garage) Name: Donald Lally
❑ Lot line adjustment 0 Minor land partition Company:
❑ Residential condominium 0 Commercial condominium Address: 8870 sw omara st
❑ Residential subdivision ❑ Commercial subdivision City, State,Zip: Tigard, Oregon, 97223
❑ Single lot commercial 0 Multi lot commercial Phone/fax: 503-970-9943
Other CAR PORT Email: raptordon69@comcast.net
6. Will the project involve any off-site work? ❑Yes ❑ No 0 Unknown
Location and description of off-site work:
7. Additional comments or information that may be needed to understand your project:
This application does NOT replace Grading and Erosion Control Permits,Connection Permits, Building Permits,Site
Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,
Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and
completed under applicable local,state,and federal law.
By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water
Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering
information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my
knowledge and belief,this information is true,complete,and accurate.
Print/type name Donald Lally Print/type title
Signature ONLINE SUBMITTAL Date 6/11/2020
FOR DISTRICT USE ONLY
O Sensitive areas potentially exist on site or within 200'of the site.THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO
ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural
Resources Assessment Report may also be required.
O Based on review of the submitted materials and best available information sensitive areas do not appear to exist on site or within 200'of the
site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if
they are subsequently discovered.This document will serve as your Service Provider Letter as required by Resolution and Order 19-5,Section
3.02.1,as amended by Resolution and Order 19-22.All required permits and approvals must be obtained and completed under applicable
local,State and federal law.
X Based on review of the submitted materials and best available information the above referenced project will not significantly impact the
existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to
evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service
Provider Letter as required by Resolution and Order 19-5, Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and
approvals must be obtained and completed under applicable local,state and federal law.
❑ THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S) ARE ATTACHED.
O The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT
OR SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by � ,.,,�,i4 -.. Date 7/7/2020
Once complete,email to:SPLReview@cleanwaterservices.org • Fax: (503) 681-4439
OR mail to: SPL Review,Clean Water Services,2550 SW Hillsboro Highway, Hillsboro, Oregon 97123
Fw¢ei 22020
Main Office • 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • p:503.681.3600 f: 503.681.3603 • cleanwaterservices.org
Julie Drinkwater
From: Agnes Lindor
Sent: Tuesday, July 7, 2020 2:26 PM
To: #Building Permit Technicians
Cc: DONALD LALLY
Subject: FW: 8870 SW Omara Carport
Attachments: 20-001648 8870 SW O'MARA STREET SPL.pdf
Hi Building Permit Techs-
Please see attached CWS letter for permit at the above address.Thanks,
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email:AgnesL@tigard-or.gov
From: DONALD LALLY<raptordon69@comcast.net>
Sent:Tuesday, July 7, 2020 2:23 PM
To:Agnes Lindor<agnesl@tigard-or.gov>
Subject: RE: 8870 SW Omara Carport
Caution!This message was sent from outside your organization. Allow sender I Block sender
Agnes please see attached copy of the sensitive area report.
Thanks Don Lally
On 07/06/2020 8:45 AM Agnes Lindor<agnesl@tigard-or.gov>wrote:
Hi Lindsey-
Mr. Lally applied for the pre-screening assessment for a carport at 8870 SW Omara and has not received
any response. Would you or someone be able to assist him with this?Thanks so much.
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
1
Phone: 503.718.2429
Email: AgnesL@tigard-or.gov
From: DONALD LALLY<raptordon69@comcast.net>
Sent: Monday,July 6, 2020 8:42 AM
To: Agnes Lindor<agnesl@tigard-or.gov>
Subject: Re: 8870 SW Omara Carport
Agnes I have tried several times to contact them on this and I do not receive any call
backs or messages? I'm not sure what I can do at this point. This process should have
only taken a max of 5 days and its been over 3 weeks? Help!!
Thanks Don Lally
On 06/11/2020 8:56 AM Agnes Lindor<agnesl@tigard-or.gov>wrote:
Hi Don-
Before we can issue your permit, you will need to submit a CWS service provider letter.
Please apply for it here (no cost):
https://www.cleanwaterservices.org/perm its-development/step-by-step-
process/environme ntal-review/
Choose the first option (Sensitive Area pre-screening), once you get the letter back from
them you can email to me.This will not hold up the review of your permit. We just need
it prior to issuance.
Thanks,
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Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email: AgnesL@ tgard-or.gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are
subject to public record laws. If requested, e-mail may be disclosed to
another party unless exempt from disclosure under Oregon Public
Records Law. E-mails are retained by the City of Tigard in compliance
with the Oregon Administrative Rules "City General Records Retention
Schedule."
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