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OE 6Z 8Z 1Z 9Z SZ 1►Z EZ ZZ I Z 0� 61 B I L I 91 51 4 I Cl 21 i I 01 6 a 1 9 S b E Z I '"'a'" J I I may,, r1111111111I11�IlIIIIIII�II1114111�f1111111 1111J11rhl{iI11u1111��1111�IMl�Iltf#�IIIIII i�r111�1�1+ 1 II �1 � II II••--_--''--__ t1 11t1111t1_ l` ritllitill4lNl1111 IilIbuill111hllIIIIII•ll111111LIIIIIlIIliIr11111111��111111111Illlllllllrll!11111,1 1ftililt ilw1 h111 .„.erg:.. , • . 1.. p•.M., yypp IR¢ " MAY 7 •� . ..... _ .. t.'-. id 1992 . lJ,.. ofI I - __... --"O.w ­ 'a. ,ft 0 ..-.-�Ir_­ 11 -,- "W • f __ I �m - -- .-.-- Etc...:..-_�......_._ ?MVIIIIii. ...iss I "L �- _...__ -._. - ""'"'•"".. -1k..1•/w•.. .� ,.•y... '` .a; ''�.., .. ,„ , x.4'1�1 .. �, . I ,*'§1'^'�+` ... ­� , r ,111'1 ;a., .. • i• . ,.,,. I r X5369 SW KENTON DRIVE -- CITY � CERTIFICATE UF OF TIGAPPOCCUPANCY CF1YOFi16s�I10 PERMIT M. . . . . . , z MT3T""a0--fd61�11 COMMUNIT`! DEVELOPMENT DF{P tT,�IIE,I�JT \ oenooN PRIM. PEkMIT M. z MST90--00 31 131?5 SWHWIBW. P.O.Bux23397,road,Oregm972M(rW)839.4175 DATE ISSUED: 06/22/90 SITE ADDRESS. . . z 15369 SW KEN'T'ON DR PAM(.EL.s 2 ii 1 l PC,'l:c_.11,000 SUBDIVISION. . . . z AfA*0RD OAKS ZONING: ULOCK. . . . . . . . . . z L.01 . . . . . . . . . . . . . : 124 CLASS OF WORK. INE::W TYPE OF USL:. . . I SF' OCCUPANCY GRP. I R;3 OCCUPANCY LOAD1220 4 TENANT NAME. . . I Romarksi T,eAr A*nding to be completed by ownrrr. Owners -.__.____.w......._.._..__..__._..._..._........ _.. __ ..__... - _ JPY MILLER 1.10 PDX 23291 i T UARD OR 9%'2:3 Thane M c 684- 1543 Contrmctorl __.. ._.._ ._._..._... ._._....._ JAY MILLER PO BOX 2:3291 T I(3ARD OR 97223 Phone Nt 694-7543 Roo N. ,.i` 30109 Orcupanry of ghat above -voterence►d bUrldinp its hereby piven, and certifies the cc-)mpli&m--,o with the! State (]f Oregon 'Specialty [_oder% for the group, orcupAllcy, and use under which the referenced poY-mit wela is+rluad. /d�7 FIRE: DEPAR'TME'NT Rl1I-i-nINt) INSF F' .IOR PIII L 1)1 HGA FFIC POST IN CONSPICUOUS PI.,.A(:'E s. INSPECTION NOTICE 4 City of Tigard Building Department l P.O. Box 23397 Tigard, Oregon 97223 ]�� Phone: 639-4175 Type of Inspection ----'-Z4,+ . Date Requested��-�—�� Time.- 1—A.M. P.M. Address .L fycl_____„ �✓ �aMIC�r� ___ Permit # 9'� Owner Lot # _ Builder 1,�/r�./L//GA The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector - _ _� Disapproved Date CALL FOR REINSPECTION U YES f_l NO � s � ss, ss, s a sssr � sssr INSPECTION NOTICE , City of Tigard Building Department P.O. Box 23397 Tigard. Oregon 97223 Phone: 039-4175 Type of Inspection Date Requested Time_ A.M. —P.M. Address " Permit Owner Lot Builder '�t_�PL The following Building Code deficiencies are required to be corrected: Ac- Ap v A-VR� Presented to _ �> �' Ipproved Inspector ,;(,' U Disapproved y Date CALL FOR REINSPECTION [___1 YES I� NO sw air si w• sss ss� sss► s INSPErTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection �- Gas Pressure Test _ Date Requested 4-11p90 Time— xx A.M.—___-P.M. Address — 15369 Kenton Permit *- 29-0('31 Owner _ Lot # �_ Builder Jay Miller The following Building Code deficiencies are required to he corrected: Presented to — _ A-Approved Inspector / — I Disapproved Date CALL FOR REINSPECTION ❑ VES ❑ NO W MEjVMjLM� INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Time/15�1 A.M..--P.M. Date Requested Address Permit *-� Owner Lot Builder The following Building Code deficiencies are required to be corrected: Presented to Approved oe Disapproved Inspector Date CALL FOR REINSPECTION YES I--] NO a i i i r� INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection '��'�"L---l --- --- --- C ite Requested Time_ _ A.M. P.M. / Address Permit Owner — _--- Lot # _ BuilderThe following Building Code deficiencies are required to be corrected: Presented to /e2 Approved Inspector � —_ l I Disapproved Date ... � � - CALL FOR REINSPECTION El YE3 I NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23391 Tigard, Oregon 97223 Phone: 639-4175 Type of inspection Ime :�=-A.M. P.M. Date Requested /Z--- Permit Address Owner Lot Builder The following Building Code deficiencies are requirer' be corrected: L4 Presented to 14�roved Inspector Disapproved Date --------- CALL FOR REINSPECTION CJ YEs El NO i i i i i i i i i tiR R C17YOFTIFARD aWOF R PERMIT COMMUNITY DEVELOPMENT DEPARTMENT BtT • • •• • : MST90-0031 13125SWHAW#&P.O.Ba:233W.7iprd.OmWxOW-MX(5o3)699rt75 PRIM. IT V : MST90-0031 — SITE ADDRESS. . . : 15369 SW KENTON DR PARCEL: 2S112CB-11000 SUBDIVISION.. . . : ASHFORD OAKS ZONING: BLOCK.. . . . .. . . .. LOT. . . .I . . . . . . . . . :124 --------------------------------- BUILDING ---------------•--------------•--------- REISSUE: DWELLING UNITS:l BASEMENT. . . . . . . . :0 of CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE.. . . . . . . . . :410 of TYPE OF USE.. . :SF FLOOR AREAS---------- REQUIRED SETBACKS---------- TYPE OF CONST. s5N FIRST. ... :8694 of LEFT. . t6 ft RIGHT. t6 ft OCCUPANCY GRP. :R3 SECOND. . . t726 of FRONT.:20 ft REAR. .:40 ft STORIES. .. .. . . :0 THIRD.... :0 of REQUIRED------------------- HEIGHT. . .. .. . . t20 ft TOTAL------:1590 of SMOKE DETECTORS. :Y FLOOR LOAD. . .. :40 psf PARKING SPACES. . :O Remarks: --------------------------------- PLUMBING ---------------------•-------...--------- SI:NKS... .. . . . . . :1 FLOOR DRA.INS. . . . to BACKFLOW PREVNfRS..:O LAVATORIES! . . . . s4 WATER HEATERS. . . :100 TRAPS... . .. . .. . . .. . to TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . .. . . . :0 WATER CLOSETS. . :2 SEWER LINE (ft) . s0 GREASE TRAPS. ... .. . :0 DISHWASHERS. . . . :1 WATER LINE (ft) . :100 OTHER FIXTURES. . . .. tO GARBAGE -DISP. . . :1 RAIN DRAIN (ft) . :0 WASHING MACH. . . :1 SF RAIN DRAINS. . :l --------------- MECHANICAL ---------------- ---------------- FEES -------------- FUEL TYPES----------- UNIT HTRS . :0 type amount by date recpt /GAS/ / / VENTS . . . . . :0 PAYM $ 100.00 JLH 01/17/90 106920 MAX INPUT:O BTU VENT FANS. . :3 PRMT $ 358.00 FURN < 100K . . :1 HOODS. . . . . . :1 PLCK $ 232.70 FURN >-100K . . :0 WOODSTOVES. :O 5PCT $ 17.90 FLOOR FURN. . . . :0 CLO DRYERS. :1 STDC $ 600.00 BOIL/CMP < 3HP:0 OTHER UNITS:O SSDC $ 250.00 GAS OUTLETS:1 PARK $ 250.00 Owner: =--------------------------------- PRMT $ 36.00 JAY MILLER PLCK $ 9.00 PO BOX 23291 5PCT $ 1.80 PRMT $ 132.50 TIGARD OR 97223 5PCT $ 6.63 Phone #: 684-7543 PAYM $ 1794.53 J`LH 03/13/90 Contractor: ----------------------------- JAY MILLER PO BOX 23291 TIGARD OR 97223 Phone 1: 684-7543 Reg a1. . : 30109 ------------------------- $ 1894.53 TOTAL This permit is issued subject to the regulations contained in the ------- REQUIRED INSPEC Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Inep Gyp B applicable laws. All work will be done in accordance with approved Poet/Beam Inep Rain plans. This permit will expire if work is not started within 180 Plm/undslab Inep Water days of issuance, or if work is suspended for more than 180 days. Mechanical Inep Appr/ Framing Inep Final Inspection Permittee Signaturet < G' Fireplace Inep �i Gas Line Inep Issued By: Insulation Inep C17YOFTIFARD C„Y0FTm WER COMMUNITY DEVELOPMENT DEPARTMENT O"gM CO ECTION 13:26 SW HA Blvd.P.O.SOK 23347.7*M.Of490d X1*(603)834.4175 RMI T PRIM. PERMIT #. t MST90-0031 DATE ISSUED: 03/13/90 SITE ADDRESS. . . : 15369 SW KENTON DR PARCEL: 2S112CB-11000 SUBDIVISION. . . . : ASHFORD OAKS ZONING: BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :124 ------------------------------------------------------------------------------- TENANT NAME. . . . . : USA NO. . . . . . . . . . :40607 FIXTURE UNITS. . . s CLASS OF WORK. . . :NEW DWELLING UNITS. . :l TYPE OF USE. . . . . ;SF NO. OF BUILDINGS:1 INSTALL TYPE. . . . tBUSWR IMPERV SURFACE. . s sof Remarks: Owner: --------•--------------------------- ---------------- FEES -------------- JAY MILLER type amount by date recpt PO BOX 23291 PRMT $ 1250.00 INSP $ 35.00 TIGARD OR 97223 PAYM $ 1285.00 JLH 03/13/90 Phone #t 684-7543 contractor: ----------------------------- JAY MILLER PO BOX 23291 TIGARD OR 97223 -----$------ ----------------------- Phone #: 684-7543 1285.00 TOTAL Reg N. . : 30109 ------- REQUIRED INSPECTIONS ------- This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 120 days from _ the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side Bower laterals. If the sewer is not located at the measurement _ given, the installer shall prospect 3 feet In all directions from _ the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. Permittee Signaturet, c_ IRsued By: Call for inspection - 639-4175 CITY OF TIGARD -- RECEIPT OF* PAYMENT RITC NOi 00107781 CHECk,'; AMOUNT "079.57) NAMEt JAY MILLER CASH AMOUNT s .00 ADDPESSi PAYMENT DAPS: TIGARD, OR 97227 K01V NOIADV 15:7,69 SW lt'.'ENT"ON VP PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID RUILDING PERMIT (1?0-0011 ' 7>58.00 PLUM14ING PERMIT 50 MECHANICAL PEP111T316.00 STATE U'UILD PERMIT TAX (5%) 46.7" PLAN CHECK FEE 141.7 0 41.70 SEWER USA (90-0054) 1125O.UO -FWEF,' INSPECWN 35.00 STREET SDC 600.Of) PAF*'S SYSTEM DFVI.",(..OPMENT CH 250.00 STOPM DPA)N SK 250,00 70TAL AMOUNT FAID — — '.079.5 CITYOF T167ARD r PLAN CHECK APPL CAT ON COMMUNITY DEVELOPMENT DEPARTMENT `~" PLAN CHECK N ISIS sw.HW@kjL .o.ew=",.ns.,aowWnan.pMg*4,n PERMIT N�11 QATt ISSUEU JOB ADDRESS:r __ I J 3 1��� S�/� I<�.. I D� J V TAX MAP/LOT SUB: �, 5 ,'l o- , S LOT: /) EJ LAND USE: VALURPION: 7,1 /&U OMNIIER SPECIAL MOTES NAME: REISSUE OF: _ ADDRESS: LAST REISSUE: FLOOD PLAIN/ SENSITIVE LAND: PHONE: APPROVALS REQUIRED CONTRACTOR PLANNING: NAME: _ Ia Mi 1 1,r gti i 1 apr, Tnn ENGINEERING: ADDRESS: P.O. Box 23291 FIRE DEPT _ _Tigard, Or c)7223 - OTHER: PHONE- --�si4-7 4_ ITEMS REQUIRED BUILDERS BOARD EXP DATE: _1.2_1 a "10 LIST/SUBCONTRACT'ORS: BUS TAX: ARCH/ENGINEER CALCULATIONS: NAME : _ TRUSS DETAILS: _ ADDRESS: OTHER: PHONE: COMMENTS: SUBCONTRACTORS: PLUMB: -Ken Watts Plmb. 56878 MECH: _Bell Heating Qn447 PERMIT N ArCT N DESCRIPTION AMOUNT AMOUNT DUE 10-432 00 Building Permit Fees 3 " OUNT PD. B3 10-411 00 Plumbing Permit Fees 10-4-11 01 Mechanical Permit Fees 10-230 Oi State Buildipq Tax (5E) Building 17, 4 o Plumbing Mach 10-433 00 Plans Check Fee ;cul,7Q X11 7 C� Building .2 32 V Plumbing - Mach ,4r 30-202 00 Sewer Connection J2 r� _ 30-444 00 Sewer Inspection 51-448 00 Street System Dew Charge (SDC) �_ 52-449 00 Parks System Dev Charge (PDC) S v 31-450 00 Storm Drainage Syst Dev Chrg (SSDC 5 -- 10-230 06 Fire ) TOTAL l3 100a1261=6 x REC N /(: i., APPLICANTSIGNATURF -. Received By: _ Date Received: j cn/3587P/18P -- # # JAY MILLER BUILDER, INC. P.O. BOX 23291, T'IGARD,OR 97223 (503)884-7543 Erosion Control Plan Ashford Oaks Subdivision 1 . Limit the amount of area disturbed during construction as much as possible. 2. Install solid gravel base driveway 20 ' min width for ingress-egress 3. Backfill foundation, and install sewer water and rain drains and backfill within 5 working days of foundation pour. Compact disturbed area w4_th normal backfilling equip- ment as needed. 4. Insta?.1 5'-6 ' gravel base 4"-6" deep along entire curb area to prevent any silt from reaching curb. 5. Use concrete pump as needed to prevent any equipment from tracking mud into street and remove any mud or soil from streets immediatiely. 6. Soil type and elevations in Ashford Oako eliminate the general need for additional ground cover. (See Burton engineering letter and calculations ) . Construction sites will be monitered by Jay Miller Builder, Inc. ::.o elimi- nate any situations arising which may need additional measures. (Straw bale sediment harrier in key locations ) BURTON ENGINEERING AND SURVEY CO. 1. 1.945 (--)W PACIFIC,' HIGHWAY #3-02 TIGARD, OREGON 9-7223 i.,H. (50:3)639-6116 FAX (503)6:39-6117 February 20, 1990 Jay Miller, Inc. PC) Box 23291 Tigard, Oregnn 9722:3 We have reviewed Ashford Oaks No. 2 subdivision for c-._3jTjpl .j.anc.-.e with new erosion control regulations as they apply to iridividUal lots for house construction. The soil. loss pet• acre for this subdiv.ision was c-alculated LASing the "Erosion Control Plans Technical buidance Handbook" The Universal Soil Loss Equation was used to calculate t.he 15oil loss for the partiCLAIAr' circumstances encountered on + his pro.ject. 'The calculation %tses the rain fall factor indicated in the tables of thi.s Handbook: for this parti::-..ular �-%rea in Tigard. The k' Value was determined from the soils type (Na. 1 , Aloha Silt froln SCS map for this area and the value then picked from the tables-, in Handbook. The LS factor- was deter-mined frt--)m the topography map for this area ( I %) and the max.imuini length at this slope (:_-_'t__)()' ) - The F'R value was picked from the Handbriok tables and requires walking over the dist-urbed area With excavation equipment to provide %c)fnr- de-gree of cnnipaction of soil .. The CalCUlatioris assumes -that 1/2 of the lot will not be disturbed by house const rt..tct.ion. The calculations shows that (). 64 ton-, per acre will erode -From the building sites. This is under- the alinwable .1 ton per- acre. Therefore no erosion contral will be required f=or this pro.ject if the pr-e -ictions are -viously mentioned unnst.t maintained. The only other requirement WOUld be eliminatiori of tracj!:it-jq soil offsite by constructs -')1'1 equipment. Thomas H. Burton, f.". F . BURTON rob / O%f ENGINEERING & SURVEYING SHEET NO. CF- 302 Tigard Plaza TIGARD. OREGON 97223 CALCULATED BY �/ _ DATE n (503)639.6116 CHECKED BY DATE SCALE d7z r. : . .................,...__ .. .... _ a _..._.»__.. _.»_.. __. ..... . - f......_, f = f. _................_..... _ .....__........_.�_„.. _..: .._ ... _.. _ : ......—_.' ' 1. . _.._...1......_.. _....... .._._..._._.._ _... ._� _ _ _ _ ......i......._.t..._._......».. .—.... ........ ._.....-.. ....f.. i II ' _... ........ .00 106. �.__... �.D PROFS : . _.. r � I I r zl �•�, ~ y LN "{1 r l• Ri� ���. r'iR9 ;Li�^4 ��'r�� 1- tr.. '". �'• � 7` `�� ,��j�f�f�7..i i�/Wh'r,,�;A .eY' ,F<Ij '�!i��..y. R4�� :+M-� �,+�,+,lt'l � ,'�' � .. �r 7�!�7 r"1•j • 'i V .ht�'�p;T � � � I ,�r 11J �a .� t 4.) �L) .:�a•�l .(�� f'r �,. •, ��. r�'� ,+ y,� ���•S�r• 1 III../ t�.�,1� GJr }i Vie4. J(.rN+ '+GbIyA!L�,x .c�p� . ys1 tA"w..� ♦ �} �r r � ,1 r f?�t�.Q t1' Sit 'ua � - ► ' 7r � 4 . �'a, p I r��'l t •` 1bi� • .l'iM1�1+ , Y tit i n �, %: �. �t r 1,+ ti ,(�ltr� �'.,r,r f.�� 1 � t�•.� �/ , '1k' 7{S I;,rt� r, �.r.��?rt•a`G� Tr�+ ';� •� r s. I�y,:,y4fi4��,kJe�"��� t7.(:� �t. °.ie ', r , ^4 , ,♦ - �,, `i: M� ( •.� .� I�Rh:r, +• w �y ,Y' '• � 'Iti .i+ x l.;j ts.� �, t.�$1��`,�;. F :�i ¢ 4th•, i r��'�• ''�u �•dJp y}I:::aA / i-..trVk.F� * ' 1 y� '�Alati{�. r ri, (,.'� Bey U.�r ;. r,' rr�'' ,.�r•ilAw�io� '/L7_ � �"r• - d�. ., � 1�1�� ��'0. iJ. -�. �';•' �-,,�. '"�ti�rjl�"�� �1 rM'y: by I ..I 1 Lj tri f, I u1 *p� 1� '' ♦ t,�!r1� 1 � � d�.I,r�� � �� ,. •a���� t�I}}- F �?�sov - /"•7 1111 ".n p, ��y' ik fid"}:la.. ���:`I�q. 'N'" k Y,����=yj• ,y � '� � � 'R 11`. .�_^-A'� .:U/ 1 �yfir� y�,r' •' tilt �.•`�.�: <'-.�1c,��C �',�./;� _,<0 ,.•,,.'M ', fr; � I , f r 5. ,�,} ti� err.'.'t +" _ ` � r y7�1♦I�f�.J' ..yx� i�L1Y� ,.tis,.!• �Mr,� ��,..- '�� F I,I i(.� d 0' t 'rr,w!t► ��r .n. 4 t.r r( 1L'-�v w "vxiYYualljj J F y� ���;f ti,�!'1 'f, I� 1' 1 lu� �,r, r r ' �k,'+'�,, `lig (f'I1; � `1r car_-; k��t'f ('A{�a��Si1 �. •� A r� t'`i�� "`A r � s'�"v'fi'�r�,. ) � s +�`�'� y"`ti -T��L�•' j� ti 33 CL II _T11.${?'t ;.r "•4 i. � � �1. r� �IIil1`� �i•{•.t���� f`N. i♦1t 9-'..Yy i k /'1.r11 }�.wa"r'•.� T. !k17 joiimg •. " L �` ''ryry ,,• �'�+t) jj •err of'r ,�� 1, CITY OF TIFAM OREGON ATTENTION CONTRACTOR The residence ycu are about to construct, altar or modify is subject to the erosion control rules that went into effect January 1, 1990. The State Environmental Quality Commission has mandated that the City enforce these rules. The following is be the minimum required fir construction on single family residences: o An approved erosion control barrier must be in place prior to any excavation or land alteration. Note, the barrier must be installed so the bottom of the barrier is a minimum of 6 inches below the original ground and anchored (see figure 3-3 or 3-4A of the technical guide book for erosion control) . o A gravel driveway must be placed immediately after the initial excavation is completed. Figure 3-2 of the Guide hook describes the gravel driveway. The note which calls for a subgrads reinforcement (filter fabric) will only be required in severe cases (were silt has worked its way through the gravel). o During the period of Oct. 1 - Apr. 30, the disturbed area of the property shall be covered with a mulch (i.e, hay, straw or bark chips, etc) with a minimum 2 inch depth, or 6 mil visqueen anchored to the ground. This cover must be installed within one week of the excavation of the property. o Catch basin inlets must be protected from erosion run off or silt that is tracked onto the street. No inspections will be approved without the erosion control in place at the appropriate time. Any excavation without the proper erosion control will result in issuance of a stop work order, and F-ssible citation Developers may submit an area wide erosion plan to cover an entire subdivision. This plan must be designed by an architect or engineer, and meet the design of the SCS Universal Soil Loss Equation. If you do not have a copy of the "Technical Guide Book for. Erosion Cor.ttol", please contact the City. Thank you for your cooperation in ti-its matter. Sincergly Brad Roast 1. Building Official 13125 SW Nall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 -- - — S.RAnING/EROSIQN CONTROL. INFORMATION GENERAL CONTRACTOR NAME&ADDRESS: CASEFILE NO.: PERMITNO.: �1�1 C` ,(" -51 _ -- - - -+-- �'Z APPLICANT NAME AND ADDRESS: EXCAVATION CONTRACTOR — ��' _I?�ICI Y ]I' ( _ NAME& ADDRESS: ----}? ` — OWNER NAME AND ADDRESS: TELEPHONE NUMBERS: — — APPLICANT`. �t f�'1 I'�`i_ PROPERTY DESCRIPTION: OWNER- _ STREET ADDRESS AND CSS STREET/LOCATED GENERAL CONTRACTOR: /S 3Z,1 -Ik— �'•''�"• L��. -- EXCAVATION CONTRACTOR: — SITI-/1C`B: _ LEGAL DESCRIPTION: 24 IiR/AFIER HOURS EMERGENCY TAX LOT NO.: 1FOrs G �> CONTACT PERSON,TITLE,T1LEPHONE: 1/4 SECTION: u f-) LL L 10( k k t I SITE SIZE,ACRES: '�-=1 t it, -- — DISTURBED/WORK AREA,ACRES: LOCATION&ADDRESS WHERI:SPOILS LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS 'TO:(CIRCLE ONE) (NOTE:PERMITS MAY BE REQUIRED) C�ATClfBASIN DITCH PIPE CREEK -11 QI Ck �c"l t I( L'14 �t (CIRCLE ONE) PRIVATE PROPERTY_ UBLIC RIGHT EROS ION/SEDIMENTATIQN CONTROLE,90 MEASURES MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION: FOLLOWING CONSTRUCTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC PERIMETER RUNOFF CONTROL. FACILI1 IES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES !'INSTRUCTION SEQUENCE OTHER OTHER PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK". EROSION CONTROL.PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY PHONE NUMBER, SCHEDULE/STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND APPLICABLE STANDARD NOTES. I HAVE READ AND WILL COP 4PLY WITH THE ABOVE AND WIL.I.CONSTRUCTAND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE. OWNER.SIGNATURE — APPLICANT SIGNATURE OFFICIAL,USE ONLY. R F.C EI1'I' DATE ACCEPTED F1if NUMBER RECEIVED BY