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12490 SW NORTH DAKOTA STREET �r""'"i°"�•...w.r, wS.��rr.:Www..�w�wMni��M�w��w.'wwr:.wsyiywW:W�.aWwwuwuiw.waw�NwMw�r.van �ra-...`w...+u.+w 12490 SW NORTH DAKOTA "''� -- Delete selected item 6AMASTER ° :MST90-0159: PROJECT:ANTON PARK STATUS:F : UPD:11/28/90: :GES: ° • PERMITTEE:JACA DORSEY HOMES PRIM. . :MST90-0159: e ° SITE ADDRE' 3:12490 SW NORTH DAKOTA ST 05 CASE HIS:.RY $$$AA$$$AAAAAA$$AAAAAAAAReq/Sent$Sctid/Due$F..:d/Done$$By$Stat$A$C A740 Insuiation Inep 10/O�/90 GS DIS ° A740 Insulation Insp 10/02/90 GS APF ° A745 Gyp Board Inep 101/08/90 KS APP ° A755 Rain drain Inep `- ° A760 Water.- Line Insp / / ° A765 Appr/Sdwlk Inep 10/11/90 CWV PASS ° A765 Appr/Sdwlk Insp 11/21/90 CWV PASS A795 Mechanical Final. 11/27/90 GS APP A797 Plumb F.Lnal 11/07/90 MS PASS A799 Building Final 11/27/90 GS APP ° A799 Building Fixe) 11/21/90 GS DIS A970 Case Finh:'.4ac. 11/27/90 GS APP ° aaAAAAAAA.iA$Af��$A�.;fAAAaAAfi$AAAAAAAAAAAA�a$55AA$$AA�4A$fi35fia5$AAAa$A$$A$AAAbAAAi ' �`� // INiYECPIOIA NOTIG'E City of Tigard Building Department 13125 SR Ball Blvd.. Tigard, Oregon 97223 nspaction i.in. (Rec-O-Phonelc 639-4175 Business Phone: 639•-4171 •peat ion:------- -----,_ �_ _� _�—�-_—. Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poat/Beam Struct. San. Sewer FramingsB1dtT. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Sinderfloor WaterLinoGyp. Bd. -Mach. Dare Requestod:_— /��'.�"�` / U j __Time: Addresss Ruilder: l __ i/ TBE FoLL)wI'fNG CORRECTIONS ARE REQUIRED: J Inspector:_ _ __ Datos1/- Z -7- ,Fc k-'�APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. CERTIFimm OF F CI� YOFTIGARD OCCUPANCY COMMUNITY DEVELOPMENT D CITYOFTMRD PERMIT' N. . . . . . . I MST96-8169 9%,n 060t,7 13125 SW Hidl Blvd. P.O.Box 23387,Tjgmd,Or 5 DATE ISSUEDN 1112.71910 S TE ADDRLSS. . . i 1,2,c)W SW NOR VH DAKOW, >1 PARCLLS IS134CF106500 '41FIDIVISION. — a ANION VARK ZONi BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . .. NOm R-7 CLASS OF' WORK. :NEW TYPE OV USE:. . . v SF OCCUPANCY ORP. IR3 OCCUPANCY LOAD 5220 4 'TENANT N,')ME. . . Ownery -___......__._.___..___..._________________---_. JACK DORSEY HOMFS 16P31 S. OAK IkEE TERRACE OREGON CITY OR 97045 ;:1101'le #1 656--64!$0 Contractors JACK DORSEY HOMES 16231 '3. OAK TREE 'T'EEE k R A U F" E)R[-.-.GON CITY OR 97045 Phiii "s 656-6450 Reg 0- 3 47550 Occupancy of the Above refourenved bctildinp Is lieveh), -ertifteq., I and t the., compliance with the State Of Oregor, Gpe(rjajty F'ode-s for the Q T,Oct p OC'C'Llpancy, and IMP Under which the referenced permit was ja4mckpd. IMENT - - PUILDINO INSPECTOR POST IN CONSPICUOI,)S PL,141. NS ECT101 NOTICE I city of Tigard 9ailding Departaent 13125 SM Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec--O-Phone): 639-4275 Business Phone: 639-4171 Footing Plbg. Underslap' Mech. Rough-in ( Appr./Sdwlk Found. Plbg. Top Out Gas Line FINALS Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line ,I Gyp. Bd. -Hach. Date Requestedr ^11 Times _AM —PM Addres ��7 s —Permit #i l/)—G�� Builders �- 1 nt$ �C:�( , `�G• L�t'C� THE FOLLOWING CORRECTIONS ARF. RFQUIRED: ver R.EPKM YARD LICA (Landscaping light) T'" CITY RIC F ►Y WrMIN 3o CALENDAR DAYS. CITY CODE ENFORCEMENT HAS BEAN ADVISED AND WILL FOLLOW UP O THIS = INSPECTION. PLEASE CALL IF YOU HAVE ANY ADDITIONAL MMIONS Inspector: Carl View Date:__11/21/'90 APPROVED DISAPPROVED _Z(_ APPROVED SUB.;ECT TO ABOVE C&11 For Reinsp. PZqjLON NOTICE Y�J'r City of Tigard Building Department 12125 SN Ball Blvd. Tigard, Oregon 97223 In petition Line (Ree-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underalab Mech. P.ough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Ream Struct. San. Sewer Framing -Rldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Undarfloor Nater Line Cyp. Bd. -Mach. Date Requested: - Time: AM PM Address: Permit : Builder: THE FOLLOWING CORRECT N3 ARE REQUIRED: ---- Inspectors--_,, -!, Date:-AP ._ •�. ` PROVED DISAPPROVED APPROVED SUr'.TFrT Tt) AROVP. / Call For Ritinsp. jam" BCTION NOTICE City of Tigard Buildlaq Departaent 13125 RN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171 Inspections----__- --- Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk Found. Plbg. Tap Out Gas Line FINAL: J Poet/Beam Struct. .San. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain I,:sulation -plumb. Plbg. Underfloor water Line Gyp. Bd. !tech. t17 Times AM —PFS Date Requested: —_. _ Address: 1 1. '. � : /37�--_— Permit: #A0 �U Builder•_ � - THE FOLLOWING CORRECTONS ARE REQUIRED: y _ Inspector:------ ------ _—�_ Dater APPROVED DISAPPROVED APFROVF.D SUBJECT TO ABOVE i Call For Peinsp. IN8pECTIOK NOTICE City of Tigard Buildiml se+.h—nt 131.25 BM Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec•-O-Phone)s 639-4175 Business Phone: 63�1-4171 i InspeatLon. —_- - ---- Footing Plbg. DndWslab Mach. Rough-in Appr/8dwlk Found. Plbg. Top Out Cas Lina FINALt Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech_ Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Rd. ) Date Requested: I� PH Address: �- 1 LJ '� _ Permit BuildersLcy_ /,, _ �� `Y J THE FOLLOWING CORRECTIONS ARE SQUIRED: — Inspectors �-— Date - APPROVED DISAPPROVED APPROVED .SUBJECT TO ABOVE Call For Reinap. i INSPECTION NOTICE City of Tigard Building Department P'0 Box 23397 Tigard, Oregon 97223 Phone: 639-4175 rr _. - --- Type of Inspection P M Date Requested - _ permit # Address Lot #___�_---------_-- Owner Builder - The following Building Code deficiencies are required to be corrected: --- - ----------- -- - ----------- ' — -- — — —= CK� pproved Presented to DisapProved Inspector Date -- CAI L FOR REINSPI?CTION (--j YES &NO INSPECTION NOTICE City of "Tigard Building Department A' - G C,/� P.O. Box 23397 a Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested me A.M..d_�P.M. Address _1C� ��'� r Permit Owner – --__— __ __ Lot # Builder The following Building Code deficiencies are requ red to be, corrected: �l2 L itil� / .Call r.�7 v^ia -- -.. Presented to _ �_ Approved Inspector Disapproved Date — CALL FOR REINSPECTION (�' YES f 7 NO INSPECTION NOTICE City of Tigard Building Department P O. Box 23397 Tigard, Oregon 97223 / Phone: 639-4175 Type of Inspection Date Requested_._ _! =_�l✓ u� M._ P.M. Address _.1_ �11� -__-_�_-? Permit # � Owner_____.____ Lot # Budder The following Building Code deficiencies are required to he corrected: , i _—C.�.�--•.� � ,d.�_ey�=/�/ �.7`' -�,gra.E�Jl� Presented to v Approved Inspector ,,r;� A __ _ ___ ❑ Disapproved Date --- CALL FOR RF,IMPECTION L:J YES (_1 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection - P�/, Date Requested -nme A.M. P.M. �._!IG— i Address _ `�-c Permit _---�"L-� ---� Lot # Owner --- Builder - The following Building Code deficiencies are required to be corrected: Presented to - _ —. r"' Approved Inspector __ 1 Disapproved Date -- CALL FOR REINSPECTION ❑ YES ❑ NO IF INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection —%��'J–� Date Requested. Time A.M.— P.M. Address Lot # Owner Builder The following Building ode deficiencies are required to be corrected: Yr- � AZ ` • i I r _- Presented to — n Approved ✓ A �. Inspector [-"r�Disapproved Date CALL FOR REINSPECTION rTllyl ❑ NO INSPECTION NOTICE City of Tigard Building Department !� P.O. Box 2.3397 Tigard, Oregon 97223 Phone: 639-4175 )) Type of Inspection Date Requested _ Time Address Permit Owner _ _ Lot # Builder ---- -- - The following Building C6Z deficiencies are required to be corrected: Presented to Inspector Disapproved Date — CALL FOR REINSPECTION ❑ YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested 7U Time-- A.M.__—_P.M. Address ____ Permit Owner- Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to �!� _ _ proved Inspector U Disapproved Date CALL FOR REINSPECTION ❑ YES F-I NO { ..... .:...........-..„.......,,.e.. ...•�.--�.aro..a.n.....ralu4+.w.asue.W�YWtiw'.wu...rr .. - INSPECTION NOTICE Jy of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 /Phone: 639-4175 Type of Inspection Date Requested G�.1lJ Time A.M.___ P.M. ' Address 1 � Permit # � -elisy Owner_ �A.--�—_— Lot Builder The following Building Codi deficiencies are required to be corrected: 12 Presented to �_ ___._..�. ___ F1 Approved Inspector ------ —._—_ -- , Disapproved Date CALL FOR REINSPECTION ❑ YE& ❑ NO INSPECTION NOTICE City of Tigard Building Department P,O. Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection Date Requested TIn1M•_--P.M. ., Address — c Permit # Owner_ Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector _ Disapproved Date CALL, FOR REINSPECTION ❑ YES 11 NO INSPECTION NOTICE �� ► � City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone! 639-4175 �+ Type of Inspection Date Requested _ r Tim�.M.�__P.M. Address s ` _ Permit Owner - __ Lot # Builder —l� The following Building Code deficiencies are required to be corrected: 4 Presented to — , yApproved Inspector _._ _ �/ Disapproved 471i Date CALL FOR REINSPECTION ❑ YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone. 639-4175 Type of Inspectionzll— Date Requested Time L r �• //� Address �,.�� ',�►� permit #�__�_� Owner Lot # Builder �. The following Building b6de deficiencies are required to be corrected: i 1 I Presented to _- _ _ �7� Approved Inspector ---- — I DISApprOVP.d Date CALL FOR REINSPECTION ❑ YES 0 NO CITY OF T IOARDr f':r;I"I]:T MASTER PE'k,M.r-J' 4i. . ... . . .. . . MSTr My )0� 01.';':) COMMUNITY DEVELOPMENT DEPAmWW TMRD PRTM. PERMIT ms'T*qo---01�,-jq I oftem 13126 SW HmN Blvd. R0.Box 23397,TigW,Oregon 972M(6W)63"171 D AT E. T SS U E D-. 0 5/:31./9 0 TT77 ni )7=761-.=. - . -if•t :07 A T SUBDI'VISION. . . . . 16134CB-06500 AMT TO III 1"'0 R K L 0Cl<. . . . . I . NO. R . . . . .. . .. . . . . . . :e7 PUILDING REISSUE: DWf7 LLING UN.11'S: 1 BOSEMENT. . . . . . . . :0 Sf C.-*I ASS OF WORK. :NEW P L.".D R M S.3 BATHS:3 GARAGE. . . . . .. „ • • . :500 Sf OF USE. SF FLOOR RE(WIRED J,yr:47 Of:.- CONS)T. u5NFIRSI . . 1007 Sf I I'--I--T. . :8 f t R 1(31-4 1'. 4 f t OU'UP ANCY GRP.:R3 SECOND. . . :803 S f FRONT. ."20 ft REAR. . .22 :0 THIRD.. 0 S f REOIJ I ft T 0 T A L-------- -.1 J.-I 1.@ 5 f SMOKE DETECTORS. Y FLOOR LOAD. . . . ..40 pin f VALUE. 81--50c 0 P A R K 111 G S PA C E S. 0 R e III a-r PLUMPING S I N K 1:3. . . . . . . . . . .. 1. FLOOR DRAINS. . . . ::0 BACKFLOW PREVNTRS. . ::(4 L 0 V A T 0 R I E 8. . . . . 94 WATr::'R HEA14"'R'13. . . I TRAPS. . . . . . . . . . . . .. TUB/SHOWERS. . . . c,3 LAUNDRY TRAYS. . 0 C A 7'(�H EI A S I N S. . . o WATER CLUSETS. . :3 SEWER LINE (ft) .. -.0 GREASE TRAPS. . . W 1)IS H W AS)H E R S. . , » : 1. WATER LINE (ft) ., - 1004 0T 14 E R FIXTURES., 0 ("')A R 14 A G E D I S P. . . RA:[N DRAIN (ft) . :0 W0SHI:NG MACH. . . 1. SF: RAIN DRAINS. . - .1. ---------'---------------------- MECHANICAL ............ FEES FUEL TYPES---.....— UNIT HTRS. . :0 type amot.tilt by date recpt /Go "/ VENTS . . . . . :0 PAYM $ 100- 00 JLH 05/1.4/'30 200-71r.--) MAX TNPUT:0 B'T'U VENT FANS. . :4 B r)R T $ 31-.311. 00 F*URN < 100K — nl HOODS. . . . . . .. .t El F)L C ili 25 4. 15 F"URN WOODSTOVI-ES. :0 D 5 P 1.9. 5";I ' :'LOOR TURN. 0 CLO DRYERS. . 1 6 TD C, 600. 00 < 131AP1.0 C)T H 1:.:R UNITS:0 ;SDC 1 i..?5 0. 0 0 GAS OUTLET So I PARK $ 250. 00 10(:,'K DORSEY HOMES .......... ....... MPRT 1" 39. 00 .', $ 9 16231 S. OAK TREE MVIL.(I TERRACE $ 1. 75. 95 OREGON CITY OR 97045s 147. 50 ''Ilmie #s 656--6450 1; 7. 38 ','rJIltY'actaru V'AYM $ 1.8'70. 28 JLH 05/28/90 1 ACK DORSEY HOMES 1.6231 S. OAK TREE TERRnu- UREGON UTTY OR 9'/045 IDIlaile 14,. 656 6450 Req ff.. . : 4'?1,550 This pereit is issued subject to the regulations contained in the 1.970. 28 TOTAL REWIRED TNsr-*#c(,T1UNS Tigard Municipal Code, State of Ore. Specialty Codes and all other FC)0t/fPmI-Id 11-Is p MeehAilic�al 1115p applicable laws. All vork will be done in accordance with approved Wt-f� F""Ofill.g F4%"I PlUmb rOP OL(t plant. This pewit will expire if work is not started within 189 days of issuance, or if work is suspended for more than 180 days. Post/DeAm 1I-ISP Framing 11-Isp CrawlD-raiii Fireplace 111sp b 4",In t. S J.a b Gas Li.ile JI)sp P1 In k-t n d e-r,r.;1.Ab PLM/Wide-rf loor r,S k.q I a t i.C, I..'is p ltsst.ted By: ........................ ........... Ftilq Drain N.-m" t Gyp Floard Itisp 'tO'r illsPectiall 639-4175 Rain drain 11-Isp SEWL'.R CONNEC F,ERM I I' V)F.R jyj l M. . . . . . . : SWR90-0176 CITYOFTIGrARD TWID VIE.RIII'T 14. : Mf,':)T90 0 1.5 COMMUNITY DEVELOPMENT DL�PAF D014" ISSUED: 05/31/90 13125 SW HWI Blvd. P.O.80K 23397,TIPM.Oreow 6 ommoc#17 1:*,AR(,'[:L--. 1S,134CB 0 G,"I 0 0 SITE ADI)Rr-.:SS. I)Al,',OTn ST R-- SUBD1V1S1(JN. . - . - ANT-UN VIARK ZONTNG: -7 PLOCK. . . . . . . . .. . .. 1_0T. . . . . . . . . . . . . ..S~7 TENAN'T NA11L. . . IJSA NO. . . ., . . . . . . c40691 FIX*T*URP—' UNII*S. . . ". CLASS OF WORK. . . -NEW 1)W E L.I—I Iq 0 L)N 1:'T S. . -. 1. NO. OF BUILDINGS: 1 T*YPE OF' USE. . . . . a SF IMPIERV SURFACE. S t TYI-E. BUSWR Rema-rks", FEES JACK DORSEY HOMES type a M 0 U 1-1 t by date r e C.,p t �1.6231 S. OAK TREE. TERRACE F#RMT t 1.250. 00 ING)P $ :35. 00 OREGON CITY OR 97045 F,AYM $ J.P85.0P .1-I-H 01,,5/28/90 V-harie 0: 656-6450 CONTRACTOR NOT ON FILE 'rolni— RE U1.)1 R E D INSr,ECTIONS This Applicant agrees to comply with all the rules and regulations Gewe-r I)-115peetiall of the Unified Sewage Agency. The permit expires 120 days from _.___......,•..._.__.__.....•..-._..._..._._.....-_...... ........ ........... the date issued. The total amount paid Hill be forfeited if the ................... ........... ................ .......... permit expires. The Agency does not guarantee the accuracy of the ,;ide sewer laterals. if the sever is not located at the measurement .•_•_•,_._.._........•.._._..._......_.....__._..._........._. .......I............................................ 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 Sever" Permit and the Agency will install a lateral. .......... ............. ................... .............. ................ ....... d B ...... 639 -417 CITY OF 'TICARD PECEIPT OF FAYMENT RECF. IPT NO. s 90-- 0 1277 9 1 CHECV AMOUNT 9 .3155- .4"E' NAME t DORSEY HOME$ omnUN7 9 n.CIO ADDRESS S. 0AV TREE TERR P(AVllF..r4T DATE-*- : 05 1 /'90 SUBDIVISION 1 1 OREGON CTTY, OR 57045- 12'4'40 NORTH DAF'OTA PURPOSE OF PAYMENT AMOUNT PAID OF PAYMENT AMOUNT PAID rv_ 50 MST 510-0 159 lQ1 .00 F No. FERM 14-7.LUMB 1 28.08 MECHANIC'Al- FE 39.CIO ST. BUILD PER FLAN C:.FIECh:". FE 1,6:1. ',0.1 SEWER USA t 1250.00 CE14EK, INSPECT 35.00 STREET SD(-, 600.00 I-.O)PK5 130c X50. 00 STOFIM DRAIN 60(" X151'?. 00 TOIAL_ AMOUNT PAID 13125 SW.Hall 0%4 PIAN C�X APPUCMai CITY OF TIG;AwRD ,� ��, ' a-, (5031639-1171 PE RMr L,T iU COMMUNITY DEVELOPMENT DEPARTMENT !D ENT DATE 1 `.. JOB ADDRESS: 1 U !ccs Al,, //1 Tax Lar: LATID USE: � SPDQAL NCS NAME. JU SI`MESUEOF: ADDRESS: IFLOW PIAIN/REISSUE: - SENSITIVE LAND: PHONE. AP --- �RBIURED C10NIFACPO�Z PLANNING: - ADDRESS: F31M DEPT c/7 0 d S OTHER: PANE: _ s o __ BTW ImO�rrRa�v BUIIDERS BOARD 1: W 7,5-,-S"G)� EXP DA32: _1 L� LT9r/ BIS TAX: ARCHIENGINEER CAtCUEAnCW: NAME: au c c cl r d TOSS DEMIES: ADDRESS: CiTH R: _ PIiDNE: CCYKI?TS: _ -- ' IrIDQi: PERM1T E ACCT f ` DESCRIPIICN 0- � )_y AM NT AM3Wr PD. BAL. DUE r� 15�0 �L!..`.�`j 10-432 00 Building Permit Fees -� 3 10-431 00 Plumbing Permit Faes "✓1`/mss'_ 10-431 01 Mechanical Permit Fees y� 10-230 01 State Building Tax (5%) - � Wilding l J :J J Plumbing 7 J Y Mech /,y� _ � --fes-`-- 10-4?3 00 Plans check Fee Building 5 y. I Plumbing Mecit 30-202 00 Sewer Cmnection 30-444 00 Sewer IrspectiOn 51-448 00 Street System Dev Charge (SDC) 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage SySt Dev Chug (SSM) s U 10-230 06 fire lum 1PPLTCA9r SI(MIZIRE i Deceived By: f ___. �_�__ Date Dived: — ei/3587P.WPF GRADINWEROSION CoNjRQL INFORMATION GENERAL CONTRACTOR NAME&ADDRESS: CASE-FILE NO.: PERMIT NO.: APPLICANT NAME AND ADDRESS: EXCAVATION CONTRACTOR NAME& ADDRESS: OWNER NAME:AND ADDRESS: TELEPHONE NUMBER,,: APPLICANT: -�Cit �-1v R s�r PROPERTY DESCRIPTION: OWNER' STREET ADDRESS AND CROSS STREETA OCATED GENERAL CONTRACTOR:-PCwse t EXCAVATION CONTRACTORi SITE-/JOB: LEGAL.DESCRIPTION: 24 14WAFTER HOURS EMERGENCY TAX LOT NO.: CONTACT PERSON,TITLE,TELEPHONE: 1/4 SECTION: l!�• �� r /_�oec.r Nv�c'S /hc SITE SIZE,ACRES: G_Gqf v DISTURBED/WORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS LEAVING SITE WILL BE TAKEN SITE RUNOFF=DRAWS TO:(CIRCLE ONE) (NOTr:PrAMnS MAY dr REQUIRrD) BATCH-BA�II�I" DITCH PIPE CREEK b�, o ��r _ (CIRCLE ONE)�'RIVATE PROPE�ETY� PUBLIC RIGHT OF WAY EROSION/SEDIMENTATION CONTROL (ESQ) MEASURES MINIMUM ESC REQUIREMENTS MINIMUM I:SC REQUIREMENTS DURING CONSTRUCTION: FOLLOWING CONSTRUCTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY FSC PERIMETER RUNOFiv CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AI 113 REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OTHER 01'HER --- PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED M 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 MEASURFS,AND APPLICABLE STANDARD NOTES. 1 HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY T6-ONTAIN SEDIMENT ON THE CONSTRUCTION SITE. OWNER SIGNATURE APPLICANT S GNATURI- Ofd iCIAL.USE ONLY. RECEIPT DATE ACCEPTED f 1.E NUMBER RECEIVED By l �