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MMD2012-00013 NOTICE OF TYPE I DECISION V MINOR MODIFICATION (MMD) 2012 -00013 MCDONALD'S REMODEL TIGARD 120 DAYS = 01 -25 -2013 SECTION I. APPLICATION SUMMARY FILE NAME: McDonald's Remodel CASE NO.: Minor Modification (MMD) MMD2012- 000013 PROPOSAL: The proposal would result in the remodel of an existing McDonald's Restaurant and associated drive- through. Proposed changes include the division of an existing single -lane drive- through to a side -by -side configuration, the relocation of an existing trash enclosure, a reduction in the number of parking spaces to accommodate the new trash enclosure, exterior facade renovations, and interior improvements. APPLICANT Robert Yagusesky Core States Engineering 150 Lake Street South, Suite 212 Kirkland, WA 98033 OWNER McDonald's Corporation 12131 113t Ave, Suite 103 Kirkland, WA 98034 LOCATION: 11201 SW Pacific Highway; WCTM 1S136DB, Tax Lot 02600. ZONING DESIGNATION: C -G: General Commercial District. The C -G zoning district is designed to accommodate a full range of retail, office and civic uses with a City -wide and even regional trade area. A wide range of uses are permitted conditionally. APPLICABLE REVIEW CRITERIA: Community Development Code Chapter 18.360.060.0 SECTION II. DECISION Notice is hereby given that the City of Tigard Community Development Director's designee has APPROVED the above request. The findings and conclusions on which the decision is based are noted in Section IV. THIS APPROVAL SHALL BE VALID FOR 18 MONTHS FROM THE EFFECTIVE DATE OF THIS DECISION. SECTION III. BACKGROUND INFORMATION Site Information: The subject parcel is located at 11201 SW Pacific Highway, at the southwest corner of Pacific Highway and 72" Avenue. The parcel is approximately 3.37 acres in size and is bounded by Pacific Highway to the north, 72n Avenue to the east, Red Rock Creek to the south, and existing commercial development MMD2012 -00013 McDonald's Remodel Page 1 of 3 to the west. Surrounding land uses in the area are predominantly strip commercial, with some single - family residential to the east and a movie theater to the south. The southern half of the subject parcel is undeveloped, with scattered tree cover. The northern half is developed with a 3,080 square foot McDonald's restaurant, a parking lot with 52 parking stalls, drive - through facilities, and associated landscaping. The McDonald's restaurant was constructed in 1997 (SDR97- 00001), with the parking area expanded two years later (SDR1999 -00027 & VAR1999- 00030). Approval of the parking lot expansion included a variance to exceed the maximum allowed number of parking spaces from 43 to 50 spaces. Proposal Description: The applicant has requested approval for the following: • Modification of the existing drive- through to add a second, parallel customer order point. • Removal of the existing trash enclosure, to be replaced with a new enclosure that would result in the removal of six existing parking spaces. • Removal of one parking space adjacent to the restaurant to allow for restriping and the construction of a new curb ramp to service the new trash enclosure and provide two ADA parking spots. • Replacement of two parking lot trees and one landscaping tree that were required at the time of initial development, but subsequently removed for unknown reasons. • Exterior facade renovation including the removal of a false mansard remove and existing wood siding, to be replaced with a combination of hardiplank siding and trim, corrugated metal, and cultured stone; new windows and doors; and the addition of aluminum canopies. • Interior renovations. SECTION IV. APPLICABLE REVIEW CRITERIA AND FINDINGS The proposed changes to the parking lot, site circulation, and structure will require a Minor Modification to Existing Development (18.360.060). Applicable review criteria and findings are below. MINOR MODIFICATION TO EXISTING DEVELOPMENT: Section 18.360.060.0 states that a minor modification shall be approved, approved with conditions or denied following the Director's review and as follows: 1. The proposed development is in compliance with all applicable requirements of this title; and FINDING: Upon review of the proposal's plans and narrative, staff finds that all applicable requirements of this title are satisfied. This criterion is met. 2. The modification is not a major modification. FINDING: Staff finds that the changes listed in TDC18.360.050.B.1 -11 are either satisfied or do not apply. Therefore, the proposed development is not a major modification. This criterion is met. CONCLUSION: The proposal is in compliance with the applicable requirements of this title and is a minor modification of existing site development. MMD2012 -00013 McDonald's Remodel Page 2 of 3 SECTION V. PROCEDURE AND APPEAL INFORMATION Notice was posted at City Hall and mailed to: X The applicant and owners X Affected government agencies Final Decision: A Minor Modification is a Type I procedure. As such, the Director's decision is final on the date it is mailed or otherwise provided to the applicant, whichever occurs first. The Director's decision may not be appealed locally and is the final decision of the City. THIS DECISION IS FINAL ON AUGUST 2, 2012 AND BECOMES EFFECTIVE ON AUGUST 3, 2012. Questions: If you have any questions, please contact John Floyd at (503)718 -2429, johnflatigard- or.gov or by mail to the City of Tigard Planning Division, Tigard City Hall, 13125 SW Hall Boulevard, Tigard, Oregon, 97223. August 2, 2012 APPR• r ` D BY: J n Floyd, Associate Planner DATE MMD2012 -00013 McDonald's Remodel Page 3 of 3 RECEIVED , GENERAL NOTES p sw "� r ivet ( 99) -- PAL" CITY OF TIGARD PLANNING /ENG � , G . ...:,.=.2=g"--...... • . A.M � _��__- __ -"!'_ I GRAPHIC SCALE ..,'° mw � '""" r r 111.1 \q \ / �,�„ ITE PLAN NOTES / k � � 1 !.' ( / , 111 ,— • Mb IL . —.a" °" _ + \ \ � f 03.0 \ F t .. . � '. ` .L. ' i:! �.. �"'.�' / C) 1 _ r' :. d.c. l:.1. f+ � �. w ..�.. . r.. / \ 1 46.ys1A.c s MESTaPUI \ e \ 1 Sr ,fir : ` +- . 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X' m X j 1• r ;t'+ • DESIGN AND DEVELOPMENT CONTACTS: SITE INFORMATION: 0 SIGN LEGEND N IMO MONET PrMar 1 a'O S OM.aara KOOPKI S USA u[ TOTAL LOT w• A . AMEX _ nm B 1!1]1 1]m • I.lE of 51111E 10.1 wF 10002 v. O �� - VOWS 4RY WIM1111 COMM MK (l' ,'° Mono) 4R �—! 1 COWL,: 404. PP/000BAO WE NmoESS I rpl SOU.1•EST )!M _ mow �w•s•>m A• o (IS) 2.2-2•615 i1GRp. M 9TSl] — s w � }+ 007“1111 COME ST•TES WMP TOT. PROMO r /0. ... %AM 5] SPACES � ,� — al ammo, $$• _ ^ '�' • " M � #O ' r ” r 6 GE M p CR - 57.00 MOO. COOED. LAM SOO ( ' LIMO sT. LOUIS. PO 651211 TOTAL .MwWrO IN/NEW n•n u WAGES ❑• � ono •• Q ( [ MUG .. eM•E,T 1,,:i w 6 ,•,S,1. Mr B 07 7 . OTT Of WOO on 11 O (C .csoM^•T «n7 M -- Q , ] 014) 843-4.320 000•601. „5 A „ O Kw, SIN MM. • M . = � Pooss � ��_ . f ;IMMW. 444 u..rf ..113. PIM 106.1, ...SO f> dl air- ..•••• ... u 0: 0,• ° ...n.. s" 4 ' , •3 C 11201 SOUTHWEST 72ND "VENUE 120141 lr�^o • ' GENERAL NOTE: CITY OF TIGARD l t � j /� n i p I SATE HIN . 511.4 •5.00 F. T WNW REPLACED AS O'ECrtOm 44c 1 SJHJiti�E Eally Ap roved �c l 1 EaW.rE au MO Maw. ura ' C R For only the work asNel� ribedZ- - 04f1I o zso �0000c 11 C2 L • PERMIT NO.. / See Letter to: Follow [ [ X I Attach Job A 1. B pate: . . lti : J ,�� RECEIVED • ,,,, I I I Ci ty ofTi ard ,,,\I"\ JUN 2 7 2012 Y g _ • F T G Minor Modification — Type I n , Oleo gING TIGARD GENERAL INFORMATION In addition, the Director must find that the proposed change is in compliance with all applicable requirements of Property Address/Location(s): <MG�oNa S Title 18 of the Tigard Development Code. To complete 11201 5W 12 AVE. ?Oft OK this review, the Applicant's proposal must include a Tax Map & Tax Lot #(s): discussion indicating how the site expansion /change will 1613 D B 02.600 continue to comply with the maximum setback, building Site Size: height, parking, and landscaping standards. Other requirements of this title such as clear vision, solid waste Applicant*: 1Z0,17414 Ybusts/C storage, non - conforming situations, signs, and tree Address: 16'O LANG ST, S. Sven Z 1 Z removal may also be applicable depending on the type and City/State: Rio li 1.A.J0 1 t W 4 i1 Zip: 1$033 location of the proposed modifications. ' Primary Contact: t s osisk 4 0,01 Dlt ✓er Phone:yZc '*D6 76'44 Fax: / E -Mail: r7A4usES kY 0 Core - 2 . uo1 halve Note .-00). co" Property Owner /Deed Holder)*: REQUIRED SUBMITTAL ELEMENTS (Attach list if more than one) le (Applications will not be accepted without the following required submittal elements) Address: Phone: City /State: Zip: Application Form ❑ Owner's Signature /Written Authorization * When the owner and the applicant are different people, the � tle Transfer Instrument or Deed applicant must be the purchaser of record or a lessee in to Plan (4 Large Plans & One — Reduced to 8' /s" x 11 ") possession with written authorization from the owner or an applicant's Statement /Narrative (4 copies) agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a IV Filing Fee $605.00 written authorization with this application. -7/cfslov, Fre. 66vr 11zipiri Oif4'crv oMt.e. Minor Modifications: Minor Modifications are processed for permitted uses and conditional uses. To review a modification as a Minor Modification, the Director must first find that the expansion FOR STAFF USE ONLY or change does not invoke one or more of the criteria , /J a�l C �w�� _ 1 discussed within Section 18.360.050(B) — Site Development Case No.(s): Review or Section 18.330.020(B)(2) — Conditional Use. If the modification exceeds the maximum allowed under any one or Other Case No.(s): more of the criteria, a Major Modification review is required. n 7/k Major Modifications are processed in the same manner as a Receipt No.: 1 new Site Development Review or Conditional Use Permit. Date: Applicant's Statement: Application Accepted By: The applicant's statement must include a summary of the Date Determined Complete: proposed changes. Criteria in either 18.360.050(B) or Revise& 7/1/11 I8.330.020(B)(2) must be addressed with a detailed response - ' " \""P \''\land use apphcarxms \minor modificanon app.docx to each criterion. Failure to provide the information needed to process the application would be reason to consider an application incomplete and delay review of the proposal. City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard- or.gov I Page 1 oft To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. (Detailed Submittal Requirement Information sheets can be obtained, upon request, for all types of Land Use Applications.) THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any deed restrictions that may be attached to or imposed upon the subject Property. • If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in the site plan, attachments, and exhibits transmitted herewith, are true; and the applicants so acknowledge that any permit issued, based on this application, and may be revoked if it is found that any such statements are false. • 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. SIGNATURES of each owner of the subject property. DATED this day of , 20 Owner's Signature Owner's Signature Owner's Signature Owner's Signature Owner's Signature Owner's Signature 4- A ?Ert Du/3510 5 w io 44 FLO'D pEED 4.OL UU PS 514JJ4WRE W►u. 13E ilto 'IiOES) 8p 0 1004c, 4c POlusitf5 APE 1 City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 -639 -4171 I www.tigard- or.gov I Page 2 oft ! 11 CITY OF TIGARD RECEIPT t 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 T!GARD Receipt Number: 187318 - 06/27/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MMD2012 -00013 Minor Modification to an Approved Plan 100 - 0000 -43116 $527.00 MMD2012 -00013 Minor Modification to an Approved Plan - 100 - 0000 -43117 $78.00 LRP MMD2012 -00013 Misc Fee 100- 0000- 45319 $45.00 Total: $650.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 33125 JFLOYD 06/27/2012 $650.00 Payor: Corestates, Inc. Total Payments: $650.00 Balance Due: $0.00 Page 1 of 1 engineering CORE STATES architecture project management construction management permitting ��, development services GROUP August 1, 2012 �I O J e PQ o �� -1 City of Tigard Planning Division � �O. X64 13125 SW Hall Blvd. Q � ( Tigard, OR 97223 SUBJECT: Response to Minor Modification Review Comments Mr. Floyd: Please review the attached material provided in response to your request for information for the pending minor modification application to the existing McDonalds restaurant located on 11201 SW 72n Ave Tigard, OR. SUMMARY: 1. As requested we have noted the location of specific trees within the site that have been previously removed and will need to be replaced as part of this application in order to receive land use approval. 2. In response to your concerns about roof top mechanical equipment screening I have provided a cut sheet for the existing HVAC units that will remain. The maximum height of the unit is 52" including the equipment curb. According to the attached building sections the minimum parapet height will be 66" above the top of the flat roof which will provide a full height equipment screen around the perimeter of the building. Should you have any questions or need additional information regarding this application please contact Robert Yagusesky or Harry Oliver at (425) 406 -7646. Sincerely, Robert Yagusesky Core States Group 150 Lake St. S. Suite 212 Kirkland, WA 98033 www.core- eng.com 150 lake street south suite 212, Kirkland, WA 98033. v:425.406.7646 georgia . virginia . new jersey . massachusetts . new brunswick, canada . missouri . florida . north carolina . arkansas . califomia . pennsylvania F -T--, I II I 1 • r_J 8 ONIH33NIJN3 /ONINNV1d 1 _ a ll -- OEIVOII JO A110 I a -°: 1 a ki ZIOZ I 911V I a �yi .1 ��ii . i ■i � .1 i -iii II1 i.iii I �Ij il I � , ii 1 n I © [� � I ll II �n a2i\1202b1 '° �► l � ''1 �1111 Il�il�l �lli�jl;` .1. 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DRS"DEnu :.%ro,u.. oa oE1N`sORD G o 1 i 11 a EDSURO FODRDA,aR SvS,E„ 5 0 i m No,. 041 Em WAR NS IRO AR RETRAIN 3 SECTION SECTION 1 SECTION % OD E t 3/4 = 1• -0- 3/ . 1.-0- 314 = 1 . -p . 038-02e0 f c &A3 2 530.18 -TG2Y UNIT DIMENSIONS (DCE AND DCG - 7 -1/2 THRU 12 -1/2 TON) COMPRESS/XI All dimensions are in inches. They are (A) BLOWER ACCESS subject to change without notice. Certified DISCONNECTED CONTROL WIRING ACCESS - (Sae Detail • •x•) dimensions will be rovided u on re uest. DISCONNECT 8wRCH ENTRY - p p Q LOCAT10N ��� T.----- ,1 - J xs33418 fl \ �� CCONDENSER OIL RETURN AIR (Dgo.lo2) I [11>/ 3syre (120) --1\ -j---.---- 47dro s) SUPPLY AIR (150) FILTER ACCESS - - CONDENSER AIR au* pirc COND. DRAIN CONN. ELEC (Soo ptex •Y• 'or location) 1 , ` 1' / t00.ti4 LHEAT�� ` r -1 '` OUTDOOR AIR (B) POWER WIRING ENTRY'', V ` ACCESS I ' (See Nall •Y• Im baton) � > (Economizer) BOTTOM supply CONTROL BOX SSW 1...- -y AND RETURN AIR-- ACCESS OPENINGS } (SEE NOTE) 611 UTILITIES ENTRY DATA 77 OPENING P F p�N T VIEW 'C':‘-\\\. 24 HOLE SIZE USED FOR \ (CIA.) ELEC /ELEC yX 7 A 3/4" KO Control Side UNITS 264" 7 7/8" KO Wirin g Bottom' �� UNIT BASE WITH RAILS (A) L c +1 + � . ` . i shorn separately Illustrate B 2" KO Power Wiring ENTRY WIRING 1 y boron uct uct openings end nd (Side or Bottom)" ENTRY 7•v4 power canneetlon locations. (B) "1„:. NOTE For curb- mounted units, C 2" KO Gas Piping (Front) POWER WIRING rdsr b Ow duct hanger dimensions D 1- 11/16" Hole Gas Piping (Bottom)• ENTRY 13-IC of the curb for the proper size of d» supply and return sir duct connections. 'Openings in the bottom of the unit can be located by the slice 7 -11 in the insulation. VENT AIR CCUPREaaoR CLEARANCES (A) SLOWER OUTLET H000 ACCESS DIELOSUPPLIED ACCESS (Si. Detail 9(1 Front 24" DISCONNECT SWITCH CanROL "P NG LOCATION ATP^ :'; ``' 12" (Less Economizer) ►—_�� Back 36" (With Economizer) 111 111 ry • �� coNceNSER Left Side (Filter Access) 24" (Less Economizer) 334/8 I _ .. COIL (With Economizer) (OgD /' Right Side (Cond. Coil) 24" ■(zoi Below Uni t 1 0" 47-7/8 � > 72" With 36" Maximum (150) I/ cotxusntw Horizontal �� \ �' I ! 7 . y . . A Naco Above Unit Overhang ALTER ACCESS - ,t-i, }►�` (For Condenser Air 7 GAS HEAT Discharge) be PVC FosALE W1 (C) ACCf ss or ooN CRAN Gas I Units may be installed on combustible floors made from wood lee Dew •r IN location) 71 .,� s2 it 1 ( , �-� ' class A, B C roof covering material. MI P'OwE WISING ENTRY'', SUPPLY 2 or Units must be installed oudoors. Overhanging structures or shrubs ENTRY (See WNW •Y• d bo � should not obstruct condenser air discharge outlet. Sorrow SUPPLY CONTROL BOX 344 I AND RETURN AR ACCESS NOTE: OPENINGS DCE Models: Units and ductwork are approved for zero clearance (SEE NOTE) to combustible materials when equipped with electric heaters. 611 / DCG Mnrlat A1' clearance must be provided between any come 0 t7 bustible material and the supply air ductwork for a distance of 3 feet r FRONT VIEW from the unit. z4 pz ' yys The products of combustion must not be allowed to accumulate `A (0) within a confined space and recirculate. GAS /ELEC GAB SUPPLY 26 ENTRY Locate unit so that the vent air outlet hood is at least: UNITS /' ' o , • Three (3) feet above any forced air inlet located within 10 horizontal (A) bottom BASE WITH RAILS feet (excluding those integral to the unit). CONTROL WIRING 7404 • Four (4) feet below, 4 horizontal feet from, or 1 foot above any door ENTRY Shown separately lo Illustrate (B) \/ tie -In bottom duct openings, power and cI or gravity air inlet into the building. an piping COnne on locations. PAVER WIRING , regulators and relief • tStq o f th e ur cr unit ENTRY refer to the duct hanger dimensions 7 -1N d the curb b the the proper ru of l FiscavrE rue of the s upply and return sir duct connections. AUG 1 2012 Unitary Products Group 17 CITY OF TIGARD PLANNING /ENGINEERING engineering CORE STATES architecture project management construction management permitting NIP21 /11111•11111110 development services GROUP June 19, 2012 RECEI SEC City of Tigard Planning Division JUN 2 7 2012 13125 SW Hall Blvd. Tigard, OR 97223 C oF PLANNIN l R! NG SUBJECT: Request for Minor Modification — Type 1 Mr. Floyd: We are requesting a Minor Modification — Type 1 to the existing McDonalds restaurant located on 11201 SW 72 Ave Tigard, OR. As previously discussed, we will provide a property owner's signature and a copy of the deed to the planning department as a requirement to release final permits. Please review the following project summary, criteria and plans for land use approval. PROJECT SUMMARY: 1. Removal of the existing single lane drive -thru with a single customer order point to be replaced with a new side by side drive -thru with two customer order points located on the west side of the property. Work will include the demolition of existing paving, curbing and order signage with the installation of new curbing, paving, order /menu signage, direction striping and landscaping needed to create the new sided by side drive -thru. 2. To accommodate the new drive -thru the existing trash enclosure will be relocated to the center section of the parking lot. Please see plan for exact location. 3. Modification of existing number of parking spaces. In order to accommodate the new drive —thru it will be necessary to remove 7 parking spaces. This will bring the number of spaces from 52 to 45 with 45 being required by local code (Table 18.765.2). 14.9 spaces per 1000 ft = 45 spaces. 4. Exterior facade renovation including the removal of the existing mansard roof and the addition of new brand facade materials as shown on the submitted building elevations. Please note the exterior renovation will remain within the existing building footprint maintaining the existing building square footage. 5. Interior renovation including new lighting, interior finishes, ADA compliant restroom update and drive -thru booth distance optimization. www.core- eng.com 150 lake street south suite 212, Kirkland, WA 98033. v:425.406.7646 georgia . virginia . new jersey . massachusetts . new brunswick, canada . missouri . florida . north Carolina . arkansas . califomia . pennsylvania PROJECT CRITERIA 18.360.050.B: 1. An increase in dwelling unit density, or lot coverage: • Existing lot coverage is scheduled to remain the same. The proposed change to the drive thru will remain within the existing paved area and will improve flow through the lot. 2. A change in the ratio or number of different types of dwelling units: • Not applicable to this application. 3. A change that requires additional on -site parking in accordance with Chapter 18.765: • 7 parking spaces will be removed but the total number of required spaces will still be met with 45 spaces provided as per table 18.765.2. There are no changes in building size that would require additional parking. 4. A change in the type of commercial structures as defined by the Uniform Building Code: • There is no proposed change to the type of commercial structure. The restaurant will remain an A -2 occupancy. 5. An increase in the height of the building(s) by more than 20%: • There is no proposed building height increase. 6. A change in the type and location of accessways and parking areas where ofsite traffic would be affected: • The proposed parking and accessways are being modified to create better circulation through the site. The interior lot changes do not affect the main access to the site from 72 Avenue. 7. An increase in vehicular traffic to andfrom the site and the increase can be expected to exceed 100 vehicles per day: A • . • The drive thru is being increased from a single order point to a side by side with two ordering points. As such increased vehicular traffic is not anticipated. The change is being made to more efficiently serve the existing customer base and improve circulation. 8. An increase in the floor area proposed for a nonresidential use by more than 10% excluding expansions under 5,000 square feet: • No proposed addition to the existing building square footage. The proposed changes to the exterior of the existing building facade are for aesthetic and branding purposes only. Building construction will remain within the existing buildings footprint. 9. A reduction in the area reserved for common open space and/or usable open space which reduces the open space area below the minimum required by this code or reduces the open space area by more than 10 %: • Landscaping and open areas to remain as is. No addition lot coverage proposed. 10. A reduction of project amenities below the minimum established by this code or by more than 10% where specified in the site plan: • Landscaping and screening areas to remain as is. No addition lot coverage proposed. Recreational facilities are not applicable to this project. Should you have any questions or need additional information regarding this application please contact Robert Yagusesky or Harry Oliver at (425) 406 -7646. Sincerely, Robert Yagusesky Core States Group 150 Lake St. S. Suite 212 Kirkland, WA 98033 Clean Water Services File Number C1eanWatcr Services ( 12 - 0 013 91 Sensitive Area Pre - Screening Site Asses anent 1. Jurisdiction: Tigard GENE ) 2. Property Information (example 1S234AB01400) 3. Owner Information JUN 27 2012 Tax lot ID(s): Name: ATTN: Adam Brandenburg Company: McDonald's USA .�LL�_ �w Address: 11201 SW U t 7 7y "^� Site Address: 11201 SW 72nd Ave City, State, Zip: Tigard, OR, 97223 City, State. Zip: Tigard, oR, 97223 phone/Fax: 425 242 2468 Nearest Cross Street: E -Mail: adam.brandenburg@us.mcd.com 4. Development Activity (check all that apply) 5. Applicant Information ❑ Addition to Single Family Residence (rooms, deck. garage) Name: Robert Yagusesk ❑ Lot Line Adjustment ❑ Minor Land Partition Company: Core States Group ❑ Residential Condominium ❑ Commercial Condominium Address: 150 Lake Street South Suite 212 ❑ Residential Subdivision ❑ Commercial Subdivision L) Single Lot Commercial C Multi Lot Commercial City. State, Zip: Kirkland, WA, 98033 Other Phone/Fax: 425 406 7646 Reconfigure existing drive thru & parking count E -Mail: ryagusesky @core - eng.com 6. Will the project Involve any off -site work? ❑ Yes No ❑ Unknown Location and description of off-site work 7. Additional comments or Information that may be needed to understand your project We a proposing a new sided by side drive thru to replace the old single dive thru configuration. 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 arid 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 Robert Yagusesk Print/Type Title ONLINE SUBMITTAL Date 6/11/2012 FOR DISTRICT USE ONLY ] 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. ] 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 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. 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- Saeenng 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 07 -20, Section 3 02.1 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 1 CWS approved site plan(s) are attached. ] 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 APPROVED Reviewed by _ .74 /7 Date , By Laurie Harris at 8:34 ant, Jun 18, 2013 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • Phone: (503) 681 -5100 • Fax. (503) 681 -4439 • www cle inwar - • . • Ar 5N p 14NY T t t t t t (Pm] aYaa a / / III'. '/. z I illr. y - 440 . 0 0 f "4. ® o VICINITY MAP t o :♦ .. % �; SITE INFORMATION: , t TV* ft, Aglik x hods / ! ® / rw 9e mus rm f�u•I Efi MO Mgt C e y o y � � � p 2F 4 — ' `a4. sera ROM a/M�W►11M S G p a t '� - Ml rlw� ySt Mm • Ma ; g tai 4 , V i r y �� a � g "�. ^ry CWS File No. 12- 001391 2 i 1�1!f; ' im APPROVED {i t-u 0 H., e / By Laurie Harris at 8:35 am, Jun 18, 2012 hi SPL Attachment 1 of 1 I , � i it ti of # Note: CWS approval is for proposed I! 1 improvements to existing drive thru and / ! 1 parking lot as shown on this attachment. / Any work south of the existing parking i lot may require additional review if E and approval by CWS. ■ C$ _. t / t a a