9889 SW KABLE STREET i
i
i
- 9889 SW KABLE STREET -
N-AEHLMLN�
CERTIFICATE OF
c
'TYoF OCCUPANCY
CffYOFTM PERMIT #. . . . . . . . MST90-0013
COMMUNW! DEVELOPMENT DEPORTMENT MOM
13126 SW HWI Blvd. P.J.Box 2A397,Tqmd,Ongm 97223 ISM)639-414) DATE ISSUED 02/13/91
)I TE ADDRE.!';1.-. 9889 13W KAbLE ST PARCEL: 2GIIICA-09900
!UBDIVISIJN. . . . s TAMI PARK ZONINf4i
)ILOC K. . . . . . . . . . x LOT. . . . . . . . . . . . .. .6
(.LASS OF ',JORIA. :NEW
T'YPE OF' USE. . . :,3F
OCCUPANCY GRP, :R3
OCCUPANCY LLAD:220 it
TENANT NAME. . . -
Re"I at-k% I
JACK BRIST01
8kI4;T0L. HOMES
11) 0 BOX 84
WEST LIAN OR 97066
I-4ione Mt 7,503-638-6640
JACK DR19TOL
6RisTm. HOMES
P 0 BOX 84
WEST LINN OR 97068
p1lone #j '503r,638-6640
999
i.11ccupmroy of the abovtA ref-ftrenced building is he(,eby given, and certifie,
1.he complianua with i-he St&tF* Of 0-egon Specialty Codes for thi group,
oc(..,upency, and' use tinder which the referenced permit was issmed.
FIRF DEPARTMENT V1j'r1!L)j NG INS~PF':C7OR
El L D I N---- Ori F I C I A
PW-.--*,'f' 119 CV)NSPJrtJOUS PLACE
INSPEMON NOTICE
C;ty of Tigard Building Dbpartment
P.O. Box 23397 f f
Tigard, Oregon 97223
//Phone: 639-4175
Typ of Inspection -_ Q4. _ _ - —_-------- --
Time A.M..._..__P.M.
Date Requested--21-1�i' 043�
-�-
Address -_-_- - - -- --- Permit # 5/=f�Q...•,�
Owner —_ --- _ Lot
The following Building Code deficiencies are required to be correctad:
14
VY
� C
a
Presented to - --- � �- cpprovat'
Inspector I I Disapprow_d
Date -
CALL FOR REINSPECTION
Cl YES 0 No �
IO <t aaI ai• aai � ew ei. I
I1;SPECTION NOTICE CJI
City of Tigard MULMn,+ Dapartaest
13125 SM ea34 Blvd. Tigard, Oreig,m 97223
Inspections Line (Roe-O- 0110): 639-4175 Busin"ka Phone. 639-4171
Inspections ,h, .
FootingP Undarelab Meck. Rough-in Appr/Sdwlk `
===+-
Found. Plbg. Top Out das Line FINALS
Poft/Beam Struct. Sen. Sewer Framing -Bldg.
Post:/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Linet� uyp. Bd. -Koch.
Date Requestede� - ( _-- Times AM PM
Address: 7— � _,--- Permit
Builders '� _-----
THE FOLLOWING CORRECTIONS ARE REQUIRM
?n
u
�M
Inspectors_,- Dates—
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call
For Refnsp.
i
1"PECTI.QNNOTICE
City of Tiyard Bulldi.n7 Department
13125 SN Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phonu)s 639-4175 Business P s 3 - 171
Inspection:
l
Footing Plbg. Underslah Mach. Rough-in Appr/Rdwlk
Found. Plbg. Top Out Gan Line FINAL:
Poet/Bona Struct. San. Sewer Framing -Bldg.
Post/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Un.lerElour Water Line cayp. Dd.,% -Hoch.
Date Requestods_y -3,'� Time: _1L_AM�r__PM
Addreses O 7 E Permit I I
BuilderAnr' ----- ---
7741 POLL40WI140 CORRECTIONP ARE REQUIRED:
I
Inspector:_ —_— _ Dntd:_ �' F?"�
L. PPROvsD DISAPPROVRD APPi;OVED SUBJECT TO ARM
Call For Reinap.
INSPECTION NOTICE
City of Tigard Puilding Department
P.U. Box 23397
Tigard, Oregon 97223
Phone: 639-41
Type of Inspection
Date Requested �1____y ___ Time A.M. P.M.
Address 2 .s r hermit #
Owner Lot #_ ---._._--
Fwilder_, __ t"6"' ,s7 L _
The following Building Code deficiencies are required to be corroded:
Presented to ____ C _ &Apprnved
Inspector -__ -- ❑ bisapproved
Date -- - -� 1- -(G�-�
CALL FOR REINSPECTION
0 YES 0 140
ri rpJ rsr rllllp
INSPECTION NOTICE
City of Tigard Building Department f
P O. Box 23397
Tigard, Oregon 9722.3
Phone: 639-4175
i
Type of Inspectiin
Date Requested lime�. A.M. —P.M.
Address ___ .1Lll. _-.._;� �s --- -- Permit #z--4 c
Owner Lot
BuilderG�' —-- ----
The following Building Code deficiencies are required to b%, corrected:
Presented to —- ---- Approved
Inspector ----_ ------ —[� ~?-�—� ---.— i I Disapproved
Date --
CALL FOR REINSPECTION
DYES ❑ NO
s■r ese asst ssts WJR Wjff WX aw sir
INSPECTION NOTICE
City of Tigard Building Department
F.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested__ Tires _ A.M._�P.M.
Address _y�-�—�— '1c�-L, �— _ .—— Permit
Owner Lot #
�T—
Builder -------- ---
The following Building Cods, deficiencies are required to be corrected:
Presented to _ Approved
Inspector �_� Disapproved
Date
CALL TOR REINSTFCTION
El YES U NO
imagers ear a att an .ew eea
INSPECTION NOTICE
Cit;, of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4.175
Type of Inspection
Date Requested_��� 7 TirmeA��.m 1,114
P.M.
Addressrmit
Owner _ Lot
Builder
The following Building Code deficiencies are required to be corrected:
i
Presented to ____- - �--`— _�Approved �-
Inspecto(�/ Disapproved
Date ��'_ - 7771 --
CALL FOR REIMPECTION
YES ❑ NO
I
INSPECTION NOTICE
City of Tigard Building Department
P() Box 23397
Tigard, Oregon 97223
Phone 639-4175 1
1 �
Type of Insoection ___�1,� _ `1 --
�f� -
Date Request-d— .�-lG Time _A.M. P.M-
Address _`. - = -�---- - ----- Permit *1?
Owner — -- Lot # -
BuilderThe following Building Code deficiencies are required to he corrected:
ce
11 Ire-
Presented to __ ,— — p❑ Q pproved
Inspector _ .-- � AC Dhepproved
Date
CALL FOR REINSPECTION
YES C7 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard. Oregon 97223
Phone: 639••4175
Type of Inspection �f1 --
?
Date Requested �--�' - � _ Time_d_. A.M. P.M.
Address ._—__-r_�
^_--____ Permit
Owner Lot
Builder
The following Building Code deficiencies are requirad to be corrected:
Presented to _- -- ---- -_ -- __�{ Approved
Inspector __ -_ --- - Diiapproved
Date ---- —
CALI, FOR RE CTION
C7 YES ❑ NO
INSPEC' A NIOTICE
City of Tigaid Building Department
P.O. Box 23.197
Tigard, Oregon 97223
Phone: 639-4175
Type of inspection t-C
Date Requested G)/� �_.-___ Time x P.M.
Address �a i ___._.. __—__ Permit �l`3
Owner- -_ _� -- - _-- Lot
Builder -----
The foilowing Building Code deficiencies arq required to he converted:
Presented to Dt'lipproved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YES � NO
4 aw. IIII ■w .� � �
INSPECTION NOTICE /
City cf Tigard Building Department
P.O. Box 23397
Tigard, Oregon 9722?
Phone: 639-4175
Type of Inspectionzz4'4rxi
Date Requested_ Time P.M.
Address --- -� !`f�`>�kr-- -- Permit
Owner Lot #_--_--
BuilderThe following Building Code deficiencies are required tc he corrected:
Presented to Approved
Inspector /_ ____ _—___ _ ❑ r1sapproved
Date !
CALL FOR REINSPECTION
M- YES 0 NO
i
INSPECTION NOTICE
Ciiy of Tigard Building Department
P.G. Box 23397
Tigard, Oregon 97223
F he ne: 639-4175
J
Type of Inspection ��_ r ---- - --- ..------
Date Requested // �j Time.__-__ A.M. . -P.M.
Address �! ,r 1 _ lL��' t.t�C —_ Permit # rxl
Owner _v Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
I
Presented to _ �—_—_ -_ �.-- Approved
jInspector .. ,[�� ..__ Disapproved
�.. ..
Date U -- -- _ ---- -- -
CALL FOR Rh:IMPF,C,'TION
YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 111AA-)
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested Time X—.. A.M.—P.M.
Address Permit
Owner Lot
E-jilder
The following Building Code deficiencies are required to be corrected:
Presented to F1 Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
OYES El NO
Iw w
C17YOFTIFARD
MASTER PERMIT
Cny F1ERn1I1. tt. . . . . . . .. IIIST90 06013
COMMUNITY DEVELOPMENT DEPARTMENT MGM
PRIM. PERMIT #. : M5T90•-001 3
13125 8W Heil Blvd. P.O.Baa 23397,TOW,Orepon 9?M`{603 80*'76 1)A T F:: ISSUED: 06/29/90
,:;ITC ADDRI:--SS. . . `:3889 SW KABLE S T PARCEL: �5111CA (d'aJ(d4i
SUBDIVISiION. . . . » '0111 PARK ZONING:
11I_0C:K. ,. . . . . . . . . : LOT. . . . . »6
__......_._...__..._.__.w._....___....__.........._.....__...__...._..w.___..... BUILDING _._..,.__.
REISSUE: DWELLING UNITS.1 BASEIrIENT. . . . . . . . :0 %-f
CLASS OF WORK. »NE14 BE:DRIIS:4 BATHS::3 GARAGE. . . . . . . .. . . :440 s>f
•TYV'E OF USE. . . :SF* FLOOR REQUIRED SE.'T'BAC:KS•_..__.__-..__.._.-_
TYV'I" OF (,0N1GT. -'5N FIRS;T. . „ . " 1.508 sf I-EFT. . :;5 ft; RIGHT. : 1.0 ft
rUG(::UPANC:Y GRP. -R13 SECOND. . . ".1623 sf FRONT. :20 ft REAR. . : 17 -ft
1:T(TFiIk% . . . . . .. . :r.' 1HI:RD. . . . :0 S 111=.;101RED---_............_......_..._.._................_................
HEIGHI.. . . . . . . . ..c0 ft T'GTAL._..___..._._......»;;31;31. +s•f SMOKE DETECTORSi. :Y
1::1...00R LGA1). . . . ..40p,_,f• VALUE::. . . . . $,-. 1.39422 PAIRI/�1.NG 9)PACES. . »0
Rcemarkse
...........__..._._ _____............____..._....._.._......_.__... _._.__.__...._.. PLUMBING
S11 14KS1. . . . . . . . . . » :I. FLOOR DRAINS. . . . :0 BACKFLOW PFCEVNTRS. . s 0
LAVATORIES. . . . . ::`5 WATER HEATERS. . . :1 TRAVIS. . . . . . . . . . . . . . »0
•TUB/f;HGWERS>. . . . :4 LAUNDRY TRAYS. . . :0 CATCH BASINS :0
WAT•EP CI.CI-L*S. . a3 SEWER L..INEr (f t) . :0 GREASE TRAVIS. . . . . . . :0
DISHWASHEWRS. . . .. : I 41qfl:::R LININ (ft) . : 1.00 OTHER FIXTURES. . . . . ..0
GARBAGE DISV'. . . : 1 RAIN DRAIN (•Ft) . a0
WASHING MA("11.. . . :1. SE•'• RAIN DROINS., . : 1
........_..........._.._._w.........._....._• MECHANICAL _....__........_.._._......_..._.._._.... _....__...._.__.___......_.._.._ F E ES ......__.,....._._....__......._........_
FUEL T'YVIE a__..._._..__...__.._._.._ UNIT HTR13. . :0 type amount by date •re•cpt;
/GAS/ / / VENTS . . . . . :0 VIAYM $ :100. 00 ;JLH 06/18/90 20177
III AX INV U T-0 BTU VENT FANS. . -4 BV'RT $ 5:33. 00
F URN ( 100K . . :0 HOODS. . . . . . . .L BV,LC $ 346. 45
FURN )=1.00K . . : :I WLTGDS3TGVE.S. :0 L45PC $ PC'. C-15
T:1.00R TURN. . . . »0 CLC) DRYERS. » 1 STDG It, 6F30. 00
OTIAE R UNITS:0 aSiDC $ 250. 00
GAS OUTLETS i l PARK $ 250. 00
0wrier: -•__._____.__........._.......____.._..........__..._._.... _..__.._...........-__ MV'RT 1i 40. 50 /
:JAC,K BRI8T0L I`IPLC 'G 1.0. 1:3 /
0RISiTGL HOMES M5V'(11 t, 2.03
F' G BOX 84 F'V'RT ti 162. 50
WL9)T LINN OR 97068 V151=1C $ 8. 1.3
1='h i1:e N: 503 638-.6640 VIAYM $ 2129. :39 .JLH 06/2'l/90
C;ontractrl r» _._........._....._.._._._..-..___..._...._....__ ...._._._._.....�_.
:JAC:K BRISTOL_
E!R I"SiT0L H0ME:S5
P (:1 BOX 84
WEST L.INN OR
V'hc)ne+ M» 50:3..-638••-6640
Reilif. « » 993 _....____._._... ._.___. _ _..,_�.___. _...._.._..__..__......_.
$ 2229. 39 TUT AL
This permit is issued subject to the regulations contained in the -- _--- REQUIRED INSF'EC11TIGh15i - - - --
Tig.rd Municipal Code, State of Ore. Specialty Codes aid all other Foot/fOUnd Ins1p Mer_hAnic.al Ir1sp
applicable laws. All work will be done in arcordance with approved Wt;r Pras.)fing L'sin V'1Umb rrsp Out
plans. This permit will expire if work is not started within 188 V'c>st/Bream Struct Framing Inscp
days of issuance, or if work is suspend for more th n 189 days. Fast/Bean I*le+rhall Fireplace Ir1sp
Crawl. Drai.11 Gas LA.rie+ Ir1s;p
,f,oalitte+e SigriAturc :: _ -:k. -/......____..:.'. ,.._.... Plni/undslab .T.r,sp YnscUlati.ctn .Tnr;rt
V'LVI/Unde•rfIoo•r Gyp Board Ir1sp
By'", _..._....__._.__..._..._...._.__..._._._.__..._.._.__ �._.._.._....._...........__._ E t n y D r a i.n B s m' t Rain d r a i.n T ri s p
Ca.l:L for inspection - 639-•4175
SEWER CONNECTION
P
CITY OF TINA RD L R I'll 11,
F.r:R 11 ry #. . . . . . . GWR9002'51
C"
COMMUNITY DEVELOPMENT DEPARTMENT 0116M F,R_[N. 1::,E R III T* Ii.. M T9 0 00:1.3
13125 SW Hyl BW. P.O.Sm 23907.TOM,Or"m OW DOIE 1c')!3L)ED: 06/2':.4/90
PARCEL- 2S111CP 09900
'-.')889 1.3W KOBI 1: -, 1
TA 111 P A R K Z 0 H I N(4
L)El 1).;.'V 1: 10 N. . . .. ;
FI L.('.)C K . . . . . . . .. I_01 G
............. ............ ...................
T EN(4NT NAME. . . . .
1.J.13 A N0. . . . . . . . . . ..42 308 F I X1 LIRE LIN FT'Ei.
1)W 1:.L..1—T N(3 LI N 1T5.. I
I
OF* WORK. III.::W
W
E OF' L)S E :9F NO. )F BL)ll_.D1N()S-. :I.
I N )TAI L.. T Y DL)5WR
F[ES ..........
JACK BRISTOL. type Aniot-trit d a te re P
I.IR113)TOL.. 1--H)MEG PRMT 1; .1250. 00
P 0 BOX 84 1 N 3 V, 4 315. 00
L..T.NN OR 97068 PPY111 1285. 00 J`1_1-4 0(1/29/90
#:
11H1ROCTOR NOT ON FTLE
............
# 12851. 00 1*0101-
Reel
R E Q(.I I.R E D iNGPECTIUNS
This Applicant agrees to comp* witii all, the rules and regulations li-isf)e(_tic)yi
of the Unified Sewage Agency. The permit expires 120 days
Ys from .......... .......
the date issued. The total amount nail will be forfeited if the .................
permit expire,-. The Agency does not guarantee the accuracy of the .........
side sewer literals. If the sewer is not located at '-he 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. .......
P -r ni i t t e 0 G j.q)-I t k.t-1,�
By:
Call fo.r irlspe(�tiovl 6394175
l-ITY OF TTOARD - RECETF-1- (11- PAYMENT r.-EC6.TF'T NO.
27.
CHECK AMOUNT a 7414. ,!lq
NAM r BRISTOL 1-40MES CASH All0UN7 a 9.(W.
D 1)F-"*E S 5 a r-,AYmEtir GATE 1 06/29
14E,,',T LINN. OP q)*"(je5B-- 'SU6D I V I:3I ON I
1-11rPOSE OF PAYMENT AMOUNT PAID I'llippr"OE OF 1"AYMENT AMOUNT PA I Cl
E4L,1:[[.,.DIPJG PF RM MST'?t',. 157,:7" f.)I) PLIMPTNG PERM
MECHANICAL F'E 40. 50 ST. PUILD 81
rLAN Cl .ECK FE 265.58 SEWER USA Of)
'
i;r-,WEE INSPECT "ps. 'lo STrTET L)r)L
"MAP
PAPV'S, SDC —50. M, STORM MAIN SDC
AMOUNT PAIL 342'
■w
CITYOFTIGARD PLAN CHECK APPL TION
anro(i'uxw PLAN CHECK (( _
COAAMUNITY DEVELOPMENT OEPARTMENT PERMIT (( J,0 - 00/
1131nSw_$(.464S4_P_0.80. =gr-n4_4o_V •.srm-(s°�l �n 0ATE ISSUCO _ — —
���5
��,�, . Ka,.�,,,ei,-s t' -;Ax MAP/LOT a.5 -
ASI-
ion ADDRE=SS: — --- LANO USC:
SUB: _��' �6.rQ� --- - LOT:
VALUATION: .--. -------_
_.._—. SPECIAL NOTES
OWNER2CISSUC OF:
NAME: 11��'�ifL_! -----—----- LAST RLISSUC: —_-
ADDRESS. _-- --� --- FE000 PLAIN/
--- — �— SENSITIVE LAND: -- —
pf10NE: — - APPROVALS REQUIRED
FLANNING:
OONTRACTOR
FIRE OF_PT — -
AOORESS: P O e OTHER: --
PIWNE: REQUIRED
--�- LISTfSU13CONMACTORS. ' —
BUS TAX:
ARCEt/FaVGINEER CALCULATIONS:
TRUSS DETAILS:
fi00RESS: = C�'iliv� - —
`.--�.... Qom- • �_1 b Zo_ PARKING PLAN:
LANOSCAPE PLAN:
PNONE: 4 G S''• �-��`� -- O171ER: -
PERMIT If ACCT IN DESCRIPTION AMOUNT AMOUNT PO. SAL.. OUE
t1l in-432 00 Building Permit Fees
10-A31 00 Plumbing Permit Fees LGA /G Z
_
10-431 01 Mechani.:al Permit Fees
10-2 3 0 01 'suildi.ng Tax (5%)
At-7 Lding
Plumbing1L�
Mesh _
10-433 00 Plans Check Fee17
Building 'y� -_L
Plumbing
rlech
Q-U:S 30-207 Oo sewer Coiinectian ---- 1��-
30-4^4 00 Sewer Inspection
51-440 M Street System Dev Cftarye (SOC) ✓ U _
52--449 00 Parks System Dev Charge (POC) ✓ --��—1
31--450 CKIStor+u Drainage Syst Oev Olt ('SOC) v, a.3 <.) _
10-230 09 TRFO ---
10-1-30 06 wasfitingLen County Fire Ot -
10-21.0 (N) Amari/wedgewood
101(11 ,.
R1 C It
j1PPL ILANT S IGNnTURL
Received By: v I vee
AMITY OF TIGARD RECEIPT Or PAYMENT RErt ETPT NCI. t9t=►-2,1C►17 7Z
CHEC E AMOUNT t ;?c►tj, t:►t t
I.lf—NME r BRISTOL . f'AM3Fi WMCll ll`aT t c;►,t.►t,�
Fi0DFtE r; F'AYME NT DATE t <.i t,'10/90
SUPPIVISICIN b
MrT LINN. OP e777t160— L 0 T 5 11, 1
Iu,l_1F'E=03E OF PAYMENT AMO(..JNT PAID F''IJE"tPOSE OF E wimEn,r AIICKINT F A I D
'PLAN C:HE.D. FE 6-40P/6-41 �: 0i), ()Q g
t+ + r
" yi
t
i.
AMOUNT PAIC1 _. .._.. yIo().oc)
ZADlNGjL,,R0Sl0N CQNff Il_Ql, INFORMATION
(;I:N]:RAI.CONTRACTOR NAME&ADDRESS: CASITILE NO.:-,.---
APPLICANT NAME:AND ADDRESS:
EXCAVATION('09FRACTOR
NAME & ADDRI-SS:
Ox -'9-14 OWNER NAME AND ADDRF-
SS:
TELEPHONE MJMIIF-'-RS:
APPLICANT: 4. PROPERTY DESCRIPTION:
OWNER: r. STREET ADDRESS AND CROSS SIKEETIL)OCATED
GENERA].CONTRACTOR:
EXCAVATION CONTRACTOR_ 3 - ` G a
SITE/JOB:
ONTRACTY,)R:-
SITE/JOB- LEGAL DESCRIPTION:
24 HRlAFTER HOURS EMERGENCY TAX LOT NO.: L
CONTACT PERSON,IIII.E,TELEPHONE: 114 SECTION:
SITE SIZE,ACRES:
DISTURBEDAVORK AREA,ACRES:
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS TO:(CIRCLE ONE)
(NOTF:Pil-MrS MAY BE REQUIRED) CATCH-BASIN DITCH PIPE CREEK
(CIRCLE ONE) PRIVATE PROPERTY
PUBLIC RIGHT OF WAY
L_RQ5jQNj.aEjgMaNT,,kTjoN CONTROL (ESO MEASURE
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DI 11?ING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMETER RUNOFFCONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION 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 NorrES COMPLETE,INCLUDING EMERGENCY
PIIOW-.NUMBER, SCHEDUI.EiNTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MPAS(JRES,AND
AI'Pl,l('AB LESTANDA M)NOTFS.
I HAVE READ AND Will cOMP�,Y WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENI'ON THE CONSTRUCTION SITE.
OWNER SI(jNATURI'- APPIJCANT SIGNATURE
OFTICIAL USE,ONLY.
DATE ACCEPI-ED
NUMBER RUCFAVED BY