MLP 9-84 POOR QUALITY RECORD
PLEASE NOTE: The original paper record has been archived and
put on microfilm. The following document is a copy of the
microfilm record converted back to digital. If you have questions
please contact City of Tigard Records Department.
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WASHINGTON COUNTY,OREGON
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PARTITION APPLICATION
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CITY OF TIGARD, 12755 SW Ash, PO Box 23397 r,
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Tigard, Oregon 97223 - (503) 639-4171 FOR STAFF USE ONLY
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CASE NO.
RECEIPT NO.
APPLICATION ACCEPTED BY .'
DATE:
_____
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1, GENERAL INFORMATION Application elements submitted:
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-4, PROPERTY ADDRESS/LOCATIONff,I,,,/ L,____ (A) Application form (1) il
-..... (B) Owner's signature/written
____ _ - - _ _ ..,;.
TAX MAP AND TAX LOT NO. V S -I- 2b Plk `1-0, k ,t, i__.2..V210 authorization
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(C) Title transfer instrument (1)
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'. /. SITE SIZE ...A0 acres (D) Assessor's map (1)
PROPERTY OWNER/DEED HOLDER* sLELDI Ti GARD (E) Plot plan (5 copies)
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ADDRESS 12766 S.W, Ash _ PHONE _E22,411.1 ____(F) Applicant's statement ...
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'. CITY J4RP ZIP _ 22223 _ _ (5 copies)
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'..;. APPLICANT* ciTY or TIGARD (G) List of property owner's d
........... . ...........................................,.......................................... ..................
ADDRESS PHONE __ within 100 feet (1)
........_ _ ______.
Z2,' CITY ZIP (H) Filing fee (Residential $150/
.......-_______0■.............v gor............*.ft.................o..............* larr......
..,': *When the owner and the applicant are different Non-Residential $300)
people, the applicant must be the purchaser of record
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or a leasee in possession with written authorization DATE DETERMINED TO BE COMPLETE:
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4,dt.4: from the owner or an agent of the owner with written
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authorization, The owner(s) must Sign this —_____
application in the space provided on page two or FINAL DECISION DEADLINE: ,
submit a written authorization with this application.
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: COMP. PLAN/ZONE DESIGNATION:
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2. PROPOSAL SUMMARY
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The owners of record of the subject property
1.,,:. request permission to divide 4.8 acres N.P.O. Number:
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(total area)
into 2 _ containing 1 .0 acres Planning Director Approv Da
al te:
(No. of parcels)
.—.......,_—.....—________
3.8 acres - - , and
-as (or square feet each. - ----- Final Approval Date:
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Planning
; y, 8ngineering
Recordation Date and Number:
..............".....................................4..........,.............—...............,...........................................,............s....,
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.,, ., 4. List any variance, conditional uses , or other land use actions to be considered
, ,.. as part of this application
SiIIIILD1102flentReview____________ _ .
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5. Applicants: To have a complete application you will need to submit attachments .
described in the attached information sheet at the time you submit this
application.
;,..., 6. THE APPLICANT(S) SHALL CERTIFY THAT:
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A. The above request d o
oes nt violate any deed restrictions that may be
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attached to or imposed uE911.....thubject property. ,
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.r.,■ B. If the application is granted, the applicant will exercise the rights ..
, ..: Wanted in accordance with the terms and subject to all the conditions and
limitations of the approval.
C. All of the above statements and the statements in the plot plan,
attachments, and exhibits transmitted herewith, are true; and the
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applicants so acknowledge that any permit issued, based on this
application) may be revoked if it is found that any such statements are
'-' false. .
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D. The applicant has read the entire contents of the application, including
the policies and criteria, and understands the requirements for approving
or denying the application.
DATED this day of ________________________19
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SIGNATURES of each owner (eg. husband and wife) of the subject property.
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(XSL:PM/0519P)
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' REQUESTS FOR COMMENTS
�` TO: ..,. __ DATE: LE191ary 17, 12§/,4_.
FROM: Tigard Planning Department
v , RE: MLP 9-84 CITY OF TIGARD. A request the City of Tigard to divide a
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4.8 acre parcepin �
to ttaoa r.ce 1s of 1.0 and 3.8 acres ach e on property .
'� 4, zoned CI3D (Central Business District). LOCATED: 13055 SW Hall (251 2DA lot 400) J;
' Attached is the Site Plan and applicant's statement for your. review. From fl',
;.,, ;,I information supplied by various departments and agencies and from other ,:'
' information available to our , staff, a report and recommendation will be
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prepared and a decision will be rendered on the proposal in the near future. '
` ' If you wish to comment on this application, we need your comments by ,7ana.v
28th ¢ 19 85 . You may use the space provided below or attach a
separate letter to return your comments. o re be to repond b tte
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above dates please phone the staff contact noted below with your comments and
confirm your comments, in writing as soon as possible. If you have any
questions regarding this matter, contact the Tigard Planning Department, P.O.
'' Box 233970 Burnham and Ash Ave. , Tigard, OR 97223. Phone: 639-4171.
r`'' STAFF CONTACT: Keith Liden .'
,� THE FOLLOWING ITEMS PLEASE CHECK TNC THAT APPLY:
�`�' We have reviewed the proposal and have°no objections to it.' J.
" Please contact of out office.
Please refer to the enclosed letter.
_. ...... .. _Written. ,comments 1 l'.
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Name of Person Commenting:
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;,, ;; Phone No.
(K3L pm/0556P)
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• NOTIFICATION LIST FOR ALL APPLICATIONS 41,\•...',
1. vr ;<<y
NPa' No. d CPC No.
2. CITY EPARTtr1ENT5 �,:
Building Inspector Engineering-Randy It,:�;,
"`' Engineering-Frank/John Parks and Recreation i..-.
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3. SPECIAL DISTRICTS I,';i,.
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Tualatin R.F.P.D. Metzger W.D.
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..r„. f4ey,
' Washington Co. F.D. No 1 -- School Dist. No 48 (Beaverton)
p''`� _.. � Tigard W.D. School Dist. Nob 23J (Tigard) C',..'
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4. AFFECTED JURISDIC`i tO S �!
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City Council Wash.Co. Land Use & Trans.Dept. ,,,,,
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p,Plann i g Com mission Boundary Commission l :,
.__ M..
Planning Department METRO I
', . 5. STATE AGENCIES (, `,
r Aeronautics Div. (ODOT) DOGAMI
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Engineer Division of State ands I';P.�,
Board of Health Commerce Dept. - M.H. Park '
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,�,,:�;; highway Div. - Terry Flink Fish & Wildlife �'�
Parks & Fiecreae Div. (ODOT) LCDG
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Subdivision Supervisor. PUC �'
,.,,_ Dept. of Energy hire Marshall a
Dept. of Envir'on. Quality Other'
6. FEDERAL AGENCIES
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Corp f Engineers�•e gineers ache 1�s,
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Post Office ,.,,
7. SPECIAL AGENCIES
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.,,�.�.., General Telephone Portland General Electric
.r r. Pacific Northwest Sell Other _- ....:..,,.rw,.._..r,.,,
Northwest Natural Cas
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So REQUESTS FOR COMMENT SENT I
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