Permit . 4
CITY OF TIGARD MASTER PERMIT
' ; s.• COMMUNITY DEVELOPMENT Permit #: MST2009-00091
T i G A R (? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/18/2009
Parcel: 1 S134DCO5000
Jurisdiction: Tigard
Site address: 11660 SW 113TH PL
Subdivision: MUTTLEYS ADDITION Lot: 25
Project: Panasewich
Project Description: Addition of 222 square feet to living room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 222 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: sf Value: $22,632.90 Rear: 15
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump. N Hoods: 0 Other Units: 1
Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add'I 500 sf: 0 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir:
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD Single Family VB R -3 222
Owner: Contractor: Required Items and Reports (Conditions)
PANASEWICH, MICHAEL R & BILLIE D OWNER
11660 SW 113TH PL
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Total Fees: $706.29
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 t ough OAR 952 - 001 -0100. You may btain a copy of the rules or direct questions to OUNC by calling 503 46.6699 or 1. 0.332. 4.
Issued By: AAA VU / A> Permittee Signature: 04. "
. ., ,
•
Buildin . Permit A 1 1 lication
REC EIVE
esidential I OR 011.IC L t til Ov1.1
APR 1 4 2009 R ece i ve d
of Tigard DateB • �� Permit No.: T2 `
I N
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.196Q_ U D GARD
Date/By: : • C9„ OdterPermit:
I I G A R [, Inspection Line: 503.639.4175
BUILDING DI VISION Date Ready/By: G ��j 7uri%: ® See Page 2 for
Internet: www.tigardor.gov I . ..,. ethod: ' 7 V�"� 1 6 Supplemental Information
TYPE OF WORK 'At REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
$ Addition/alteration /replacement ❑ Other: equipment, materials, labor, overheac,,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. `)p a 1 ( 2 .9 O
1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 0
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: )) t ‘ ...» / J3 P4 G}, New dwelling area: squa�r feet 7 �
City/State /ZIP: 'T'") / 4 R,� ? -7 .2 2 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: d Project name: Al ' 4 i. w ) 4^ H k / pe Covered porch area: square feet
Cross street/directions to job site: l ei A. )€49 S Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivisiony l g r n j S y j A r7 4 / n0 rl I Lot no.: , Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK //l work indicated on this application.
4 6 1) / 7 T L / t/ / T/6-, ✓ 0 iv\ Valuation: $
Existing building area: square feet
New building area: square feet
I
PROPERTY OWNER ❑ TENANT Number of stories:
Name: ti 1 o EL dij7Jf} -5 2_ w c.-1+ i Type of construction:
Address: (1 41 o A.A.) l 12J Pt . Occupancy groups:
City/State /ZIP: 6 b 12. 9 -2- 3 Existing:
Phone: ( ) 6. 5.-& 3 C2_ Fax: ( ) New:
❑ APPLICANT ` ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR
Business name: C� BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State/ZIP: Structural plan review fee (or deposit): l O U . L? - 5
Phone: ( ) I F es: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received:
Authorized signature: %�1ij�� /// This permit application expires if a permit is not obtained
�/� within 180 days after it has been accepted as complete.
Print name: 7Lf -r! 4S,P -/ / 91, a A e 6 Date: q �o ../2 7 • Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB)
' Electrical Permit Application FOR 01.1-11 I I `,1 ( ?NI 1
I N ,
City of Tigard Received
` Date/B :
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
f WARD Inspection Line: 503.639.4175 Date Ready/By: Iuris: Pi See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction A Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
,P 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
Additio
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 °, "1 -3 ",
/ ! 100HP or more. occupancy.
Job no.: Job site address
/1 O C [7 S ti✓ //3 �[,g E ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 7 ❑ Health - care facilities. ❑ Supply voltage for more than
�/ �( /� / 2 t' �� 9 . 2 . 2 3 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: /� a% E n ❑ Service or feeder 600 amps or more.
r S wiGN xis )/>�NCf FEE SCHEDULE
Cross street/directions to job site: 7-1 t, R Q.0 S ' 7 - Description I Qty. I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
/- w r y S / y Q R / 7 D N ZS Ea. add] 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family
75.00 2
4 De / T / 0 )-I 1 p L / 1/ / Nan Roo a M residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
VI PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2
Name: A me f g C i � ; P H 401 amps to 600 amps 160.60 2
/' ' +'¢� S C 601 amps to 1,000 amps 240.60 2
Address: / / 6'
' t 0 - ki `1 3 % 101_74 ri Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP:
-7-/ 4, 4 - k D 401 9 7 3 2 3 relocation
Phone: Cco3 ) 6,7 7 , 6 3 S Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is be' made on pr erty that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, r Owner si afore: ording t RS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
)Ik 71 7 4/ -. /c p 1 Branch circuits - new, alteration, or extension, 1 r panel
66 D ate:
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 4.i 2
first branch circuit
Address: Each add'l branch circuit / 6.65 (- 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: (�
D� t' v G - v Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 5:
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): r 5fr? Authorized signature: Z /��2 TOTAL PERMIT FEE: , 9 z,
This permit application expires if a permit is not obtained within 180
Print name: F i .w�r� /wt t- yy,/ Date: 4 --/0 . -09 days after it has been accepted as complete.
/ * Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 46I5T(I1 /05 /COM/WEB
Mechanical Permit Application 1 -0R of l 1 F t wl O\I 1
,
City of Tigard Received
Permit No:
IN • 13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
= Phone: 503.639.4171 Fax: 503.598.1960 Plan Review DateJBy: Other Permit:
T I GA RD Inspection Line: 503.639.4175 Date Ready /By: Juris: PI See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
1:1 New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
1- and 2-family dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
l / 61 �� 3 P� G (requires site plan showing placement) 14.00
City/State /ZIP: p Furnace 100,000 BTU (ducts/vents) 14.00
/ /� �r� �� Z a Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: � CEIa/7CN pump Y L� i l) ,NC Gas heat um 14.00
Cross street/directions to job site: % l 6, d AD � j p _ i ` - r Duct work J 10.00 jD- DO • / Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
ivision �V , / Lot no 2,s---. Flue/vent for any of above 6.80
Subd � ii .. S ,4 , , , 0 it) Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater I I 10.00
(�
Gas fireplace 10.00
4 09 f) 17 )n Jl / Y ) , Z- / I )4 RO . Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
ig. PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: /111 ,i )j E f G t /. Jv As ( L✓ i c r 1 Environmental exhaust and ventilation
/ 7 / �l � Range hood/other kitchen
Address:
j/ � t7 D S w 1 / 3i �L/7 C equipment 10.00
City /State /ZIP: 7", la, f1 f D 0A. 9 "72 2 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (6"0,1 ) 6 ,? 9 -, 63.S Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
c
Business name: EJ2 Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal {Q, CO
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) ea,n�
Plan review (25% of permit fee)
CCB lic.: ' State surcharge (12% of permit fee) ,7 0
'� TOTAL PERMIT FEE , t) •
Authorized signature �,� / This permit application expires if a permit is not obtain within 180
I' / lI/ ,/ days after it has been accepted as complete.
Print name: a , r ;CA 4e ( Date: q -/Q -0 y * Fee methodology set by Tri -County Building Industry Service Board
r:\ Bu g\Permits\MEC- PennitApp -doc 01/19/07 440- 4617T(II/02/COM/WEB)
,
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE l SE O\1.1
City of Tigard Received Permit Na.:
i ti • 1 3125 S Hall Blvd., T igard, OR 97223
Associated
O Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
TIGARD
24- Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard- or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQI "IRED FOR I'L:kN`REVIEW le No y','
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ■ • •
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑
3 Verification of approved plat/lot. ❑ ❑
4 Fire district approval required. Name of district: . ❑ Q_ ❑
5 Septic systempermit or authorization for remodel. Existing system capacity ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
basin protection, etc: .
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and
surface drainage.
_
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ^ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss desn details. ❑ ❑ , El
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be . r tlicable to the .ro"ect under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ 0
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, 0 ❑ ❑
and protection measures must be drawn to scale and accompanied by the project arborist's signature of approval.
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
r:\ Building \Pennits\BUP- RES- PermitApp.doc 03/21/06 440.4613T(11a21COM/WEB)
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.055 (4))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
C I will be performing work on property I own, a residence that I reside in, or a residence that I will
L:
47 reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
,�✓1 d, A l c. f - 11 , w;1X .
Print Name of Permi pplicant
W 4 r 6 ?.
Signature of Permit Applicant Date
Permit #: 451- ADO 600q ,
Address: H t /00 6L0 I J Z
sh• Issued Date: /A9 /0, t
This Copy for Permit Offices
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APR 1 4 2009 //O .5 tA/ H3 (14-ct
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CITY OF TIGARD
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CITY OF TIGARI) - SITE PLAN REVIEW
CITY OF TIGARD -SITE PLAN REVIEW BUILDING PERMIT NO.: 1(�S� o4 _ coact c_
BUILDING PERMIT NO: .." 20661- *00°' PLANN DIVISION:
Required Set cks: ;Approved
Street Trees:
Side: ❑ Not Approved
A pproved ❑NotApp�oved ! Street Side:
Protected E 1------ . Approved ❑ Not Front. ?� Rear:
Garage:
B : s �j„ Date: Approved
Visual Clearance: A proves ❑ Not Approved
Notes: ��
klaaimum Building He! •Iit• -� fe t
•e Provider Letter Required: IS. Yes ❑ No
i :� 9 eceed
I t ' Date: ee1
ENGINEERING DEPARTMENT:
Actual Slope:. %pproved ❑ Not Approved
Site Plan: Er pproved ❑ NNo,
ott Approved
By: J)ll !➢tj Date: 4z'
Notes: