Correspondence ivv. d 7
Clean Water Services-Service Provider Letter RECEIVED
NOV 0 3 ZOtO
•
CITY OF TIGARD
Submission Date: 10/13/2020 Confirmation#: 493UICDJNG D►�)SIQN
Applicant Name: Babak Jabbari Review Type: Partner City Plan Review
Contact Email: craftmaster@live.com Ground Disturbance: 300 Sq. Ft.
Contact Phone: 503-997-7172 New Impervious Area: 300 Sq. Ft.
Primary Address: 14143 SW ALPINE CREST Mod. Impervious Area: 0 Sq. Ft.
Primary Jurisdiction: Tigard Development Activity: Single-Family Dwelling Addition
Affected Tax Lots: 25109AB15600
INSTRUCTIONS:This pre-screening report is the Service Provider Letter(SPL)as required by Resolution and Order 19-5,Section
3.02.1,as amended by Resolution and Order 19-22. PROVIDE A COPY OF THIS SPL TO THE JURISDICTION RESPONSIBLE FOR LAND
USE REVIEW AND PERMIT ISSUANCE.This pre-screening review does NOT eliminate the need to evaluate and protect water quality
sensitive areas if they are subsequently discovered and this review does NOT eliminate the need to obtain additional CWS permits
or reviews if project changes in scope or location.All required permits and approvals must be obtained and completed under
applicable local,State and federal law.
Permit or Review ' Required' Next Steps _ ' ' : ,
Environmental Site Assessment No
Review
ater Quality Treatment Review TBD Contact city(primary jurisdiction)responsible for land use review and permit
j and Stormwater Inspection issuance.
Erosion Control Inspection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Erosion Control Inspection Permit TBD Contact city(primary jurisdiction) responsible for land use review and permit
with Site Plan issuance.
Line Tap Inspection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Disconnection Permit TBD Contact city(primary jurisdiction) responsible for land use review and permit
issuance.
Connection Permit TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
Connection Permit with Plumbing TBD Contact city(primary jurisdiction)responsible for land use review and permit
Plan issuance.
Easement Review TBD Contact city(primary jurisdiction)responsible for land use review and permit
issuance.
�he CWS Development Services group is here to review your project in the most effective and efficient way,while protecting the Tualatin River Watershed.Our
partners include municipalities,environmental organizations,and developers large and small.
Contact Us 2550 SW Hillsboro Highway*Hillsboro,Oregon 97123
phone:503-681-5100*email:splreview@cleanwaterservices.org*website:www.cleanwaterservices.org/permits-development