15745 SW 82ND AVENUE i
-' 15745 SW 82ND AVENUE ��
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone 639-4175
r
Type of inspection �i _pt✓ 1
Date Requested—
` yQ_ Time A.M. P.M.
Address22i' __ Permit y�
Owner ----- -- - -- Lot ---
Builder ---------- --- ------ --._._.__._----------
The following Building Code deficiencies are required to be corrected:
Presented to j _ _ [%Approved
V
Inspertor r —_—__ [-� Disapproved
Date
CALL FOR REINSP
E�' N
Cl YES I�'No
I
WI I
CERTIFICATE OF
OCCUPANCY
CITY®F TIFr.,.. PERMIT N. . . . . . . a MST910-0041
�RPCITYOFTWARD P IM. PERMIT M. i MST90-0041
( 7
rm
COMMUNITY DEVELOPMENT DEPARTMENT GON DATE ISSUEDs 26/24/90
13125 SW H&JI Btvd. P.O.Bon 23397.Tigard.Oregon 97223(503)639-4175
AVVKtbb. . . ; 1Z)/APD detfl) RVE — PARCEL: SFl-2CC---75@@
SUBDIVISION. . . . 9 LANG I E ZONINGs
BIOCK. . . . . . . . . . j LOT. . . . . . . . . . . . . 17
CLASS OF WORK. oNEW
TYPE OF USE. . . t SF
OCCUPANCY GRP. iR3
OCCUPANCY LOADs222 4
TENANT NAME— :
Rema 0,F,I
Owner --------------- - ----------------
TITAN PROPERTIES
PO BOX 6835
ALOHA OR '97007
Phone 141 64554TI
Contracfor m
TITAN PROPERTIE'S
PO BOX 6835
ALOHA OR 97007
Phone Ov 6456477
Req #. . s 30558
occupancy (if tliv atiove referenred building is hereby given, and cortifieffi
the compltaiirta with the State Of Oregovi Specialty Code'.4 for the group,
ficcupancy, and u%e under- which the r(oferenced permit: wao.k issued.
/ �r...G' L ____- -
Z---
F-IRE DLPARTMENJ* B.U. LIfING IN TOR
POST IN CONSPICUOUS PLACE
INSPECTION NOTICE
City of Tigard Building Department
P O Box 23397
Tigard. Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested y – �/Q Time V^_ A.M. P.M/�/���
Address — l .5 7��� �4 h d _^_�_ Permit # Vei7�
Owner_ _ Lot
Builder
The following Building Code defici,ncies are required to be corrected:
71
-- -- �1 – - --
—-- —
r �
Presented to _ — l`f"Approved
Inspector _ _ _ [] biapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
INSPECTION NOTICIE
City of Tigard Buildinq Department
P O Box 23397
Tigard, Oregon 97223
Phone F39-4175
/ j
Type of InspeCtiott ��C// "` d�C�'
Date Requested .3 7� - Time A.M. P,M,
Address y s(�/ 2 N6) �`
Permit # -U—100L//
Owner
-- — ___-- Lot # _
Builder ( —
The following Building Code deficiencies are required to be corrected:
Presented to
F] Approved
Inspector
Date --
CAL FOR REINSPECTION
DYE$ D NO
i
FEW vc���Igmm
INSPECTION NOTICE
City of Tigard Bu;lding Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection � � ,
Date Requested
•� G d Time ---- A.M. p_P.M.
Addrass Permit
Owner _ Lot # --
Builder
The following Building Code deficiencies are required to be corrected:
AeT
---------------
tic xec>oe
Z,11
Presented
i - ---- ---
a3�C
Presented to z
7f& - _=M� I
!nspector _�_ y( E"l proved
Date --- - / _
CALL OR REINSPECTION
/,^YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Departrnant
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection -=z14LL=
Date Requested. �d Tim! A.M. _P.M.
Address ---- �� .,�-"� 007 Permit
Owner - -_ Lot _
BuilderQ
The following Bui:ji,ig Code deficiencies are required to be corrected:
r'-]!E0
presented to - - C] Approved
Inspector _ _ —_ / _ _ L}- fhpproved
Date - - -
CALL FOR R NSPECTION
WrViES 0 NO
INSPECTION NOTICE -T
City of Tigard Building Department
P.O. Box 23397
Tigard. Oregon 97223
Phone 639-4175
Type of Inspection
Cate Requested '`" U y e Time A.M. _"� P.M.
Address 15 7y5 �� �j Permit # �D `OL)–,//
Ow er- Lot #
Q-+ilder Z--"/ —
The following Building Code deficiencies are required to be corrected:
Prpsentf�d to .. " -- -- Approved
Inspector
--_ D Disapproved
Clete
CALL FOR REINSPECTION
DYES ONO
1
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type o` 'nspection
Date Requested_____2 =, /tJ � — Ti A.M._____P.M.
Address �1 7 �cO �l Permit # /
i
Owner_— _. _ Lot # _J _.._
Guilder
The following Building Code deficiencies are required to be corrected:
Presented to 71t _
'L't'�pprovea
Inspector ` Disapproved
Date 7- '�Ju
CALL FOP REINSPECTION
❑ vee E- 1VTO .
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�AMASTER PERMITAAAAAAAAAAAAAaaA� aa• :MST90-0041: PROJECT:LANGTREE STATUS:I : UPD:06/25/9 :MS• PERMITTEE:TITAN PROPERTIES PRIM. . :MST90 041.SITE ADDRESS:15745 SW 82ND AVE
CSA CASE HISTORY AAAAAAA&Ah&&&A&6&666&&&5Rcq/Sent&Schd/Due6End/Done&AByAStat °
A705 Foot/found Insp 03/15/90 TLP PASS
A710 Poet/Beam Insp 04/04/90 RT PASS °
A717 PLM/Underfloor 04/04/90 MS PASS °
A720 Mechanical Inep
A722 Plumb Top Out
° A725 Framing Inep 06/26/90 TLP PASS
A730 Fireplace Inep 06/03./90 TLP APP °
A735 Gas Line Inep 06/26/90 TLP PASS
A740 Insulation Insp 06/26/90 TLP PASS
A745 Gyp Board Insp 07/03/90 TLP PASS
°
A755 Rain drain Insp / /
A760 Water Line Inep
° A765 Appr/Sdwlk Insp 07/02/90 MM PASS °
n A795 Mechanical Final
A797 Plumb Final 08/10/90 TLP . ASS
AA�aaAAaAAAAAAAAAAAAAAAAAaAAAAAAAAAAAAAAAAAAAA3AAAAAAAAAAAAAAAAAAAAAAA3AAa4AAAi.
HISTORY: VIEW UPDATE DELETE I;SC
View comments for selected item
6AMASTER PERMITAAAAAAA,4AAAAAAAAaAHSAAAAAAAAaAAAAAaAAASAAAAAAAAAAAAAaAAAsAAAAAAfi
:MST90-0041: PROJECT:LANGTREE STATU5: 7 : UPD:06/25/90: :MST: °
PERMITTEE:TITAN PROPERTIES PRIM. . :MST90--0041:
SITE ADDRESS:15745 SW 82ND AVE °
OA CASE HISTORY AAAAAAAAAAAAAAA7i4AAAAAAAReq/SentbSchd/Due3E:ld/honeAAByAStathiAt
A705 Foot/found Inep 03/15/90 TLP PASS °
° A710 Post/Ream Inep 0�/U4/40 RT PASS °
o A71.7 PLM/Underfloor 04/04/90 M5 PASS `
° A720 Mechanical Inep / / °
\7,'.e Plumb Top Out
° A/25 Framing Inep 06/26/90 TLP PASS
° A730 Fireplace Inep 06/01j90 TLP APP '
° A735 Gas Line Insp 06/26%90 TLP PASS °
^ A740 Insulation Inep 06/26/90 ,LP PASS '
° A745 Gyp Boar'. Inep 07/03/90 TLP PASS '
A755 Rain drain Inep / / °
A760 Water Line Insp
A765 Appr/Sdwl1 Inep 07/02/90 MM PASS "
° A795 Mechanical Final
A797 Plumb Final 08/10/90 TLP PASS
AAAAAAAA AAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAhAAAAAAAAAAAAAAAAA,
HISTORY: VIEW UPDATE DELETE ESC
View comments for selected item
6AMA8T'" '� �� �, �4�fi��11c�Ar'�,AAA�i A�A9a b dAAat+k1'A AA�f�AAE�6ltAl4A�__-�_
° A_799 Final Inspection °
° -�-- 08/15/90 TLP
A799 Building Fina'. 08/17/90 TLP FAI °
° A003 Pre-applicP4.;.on meeting
CITYOFE TI17ARD
OREGON
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HISTORY: VIEW UPDATE DELETE ESC
View comments for selected item
6AMASTERo PERMTTAAAAAAAAAAAAAAAAAzAAAAAAAAaAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAC
:MST90-0041: PROJECT:LANGTREE STA'PUS:I : UPD:06/25/90: :MST: °
PF.RMITTEE:TITAN PROPERTIES PRIM. . :MST90-0041: °
SITE ADDRESS:15745 SW 82ND AVE °
OA CASE HISTORY AAASAAAAAAAAAAAAAAA&AAiaReq/Sent&Schd/Due&End/DonelkAByfiStatfiAtiC
° A799 Final Inspection 08/15/90 TLP FAIL °
A799 Building Final 08/17/90 TLP FAIL °
A003 Pre-application meeting
AAAAAAAAAAAAA€�AAAAAAAAAAASAAAAAAASAAAfA�iAAAAAAAAAAAAAAAAa�►AAA3AAA5AAAAAAriA�A�Ai
13125 SW Hall Blvd.,P O.Box 23397,Tigard,Oregon 97223 (503)639-4171 --
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INSPECTION NOTICE ��
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested +�G - Time A.M.. P.M.
Address 1,�!._ i � —h -- F---- Permit
Owner _ Lot #----- ------
Builder
The ioilowing Building Code deficiencies are required to be corrected:
a
Presented tov pproved
Inspector ✓ _ D\iUpproved
Date
CALL FOR REINSPECTION
0 YES D NO
F
I
i• ! ii � � ! t � �
INSPECTION NOTICE
City of Tigard Building Department
P.O. Rox 23397
Tigard, Oregon 97223
Phone: 6/39_-4175
Type of Inspection ��tr�J�.L�� `—,L',, _
Date Requested 1 y f li Time M. _P.M.
Address `7 r Permit 1-76
— �t
Owner
_._ Lot #
Builder _
The following Building Code deficiencies are required to be corrected:
Presented tom, - Approved
Inspector ' ca
I Disapproved
Dots
CALL FOR REINSPECTION
0 Y18 F1 NO
1
INSPECTION NOTICE
rilut of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639.4175
Type of InsNvction
Date Regv9steo --y — Time A.M. P.M.
Address _�, 7L—L5— — Permit
Lot
Owner
Of
Builder
The following Building Code deficiencies are required to be corrected:
� —
Ai
V
Presented to F1 Approved
Inspector ,,� J U Disapproved
Data --�—�—
CALL FOR REINSPECTION
❑ YEs 0 NO
CITY"OFTIGARD 4
COMMUNITY DEVELOPMENT DEPARTMENT CITY PERMIT
13125 SW Nall Blvd. P.O.Box 23397,Tigard,Or9gOn 97223 (503)639.4175 �E �Y• -• • • • MST90-0041
XXXX PR�IM.�__ I *. : MST90-0041
639--4171 DATE ISSUED: 02/08)r§-O------
(
2 08 90 —.
ITE ADDRESS. . . : 15745 SW 82ND AVE PARCEL: 2S112CC-7500
UBDIVISION. . . . : LANGTREE ZONING:
LOC+i. . . . . . . . . . . LOT. . . . . . . . . . . . . :7
------------------------------- BUILDING ----------------•--------------------
ISSUE:MST90-0040 DWELLING UNITS:1 BASEMENT. . . . . . . . :0 of
SS OF WORK. :NEW BEDRMS:3 BATHS:3 GARI E. . . . . . . . . . :353 of
1C1'G
E OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS----------
E OF CONST. :5N FIRST. . . . :950 of LEFT. . :5 ft RIGHT. :5 ft
UPANCY GRP. :R3 SECOND. . . :698 1i FRONT. :20 ft RF.AR. . :33 ft
RIES. . . . . . . :0 THIRD. . . . :0 sf.` REQUIRED-------------------
HT. . . . . . . . :222 ft TOTAL,------:1648 of SMOKE DETECTORS. :Y
�LOO R LOAD. . . . :40 pef PARKING SPACES. . :O
Remarks:
--------------------------------- PLUMBING
------------------------------------
SINKS. . . . . . . . . . :1 FLOOR ►,RAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :3 WATR P.EATERS. . . :100 TRAPS. . :0
tUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
ATER CLOSETS. . :3 SEWER LINE (ft) . :O GREASE TRAPS. . . . . . . :0
ISHWASHERS. . . . :1 WATER LINE (ft) . :100 OTHER FIXTURES. . . . . :0
ARBAGE PTSP. . . :1 RAIN DRAIN (ft) . :O
ASHING MACH. . . :1 SF RAIN DRAINS. . :1
-------------- MECHANICAL ------- -------- ----------------- FEES --------------
FUEL TYPES------------ UNIT HTIS. :0 type amount by date recpt
,/GAS/ / / VENTS . . . . . :0 PRMT $ 361.00
�iAX INPUT:O BTU VENT FANS. . :4 PLCK $ 40, 00
�FURN < 100K . . :1 HOODS. . . . . . :1 5PCT $ 18.05
OURN >=100K . . :0 WOODSTOVES. :O PAYM $ 40.00 JLH 01/24/90
(FLOOR FURN. . . . ..0 CLO DRYERS. :1 STDC $ 600.00
(BOIL/CY? < 3HP:0 OTHER UNITS:O SSDC $ 250.00
GAS OUTLETS:1 PARK $ 250.00
(Owner: ---------------------------------- PRMT $ 39.00
TITAN PROPERTIES PLCK $ 9.75
PO BOX 6835 5PCT $ 1.95
PRIAT $ 132.50
,ALOHA OR 97007 52rr $ 6.63
Phone N: 6455477 MISC $ 15.00
Contractor: ----------------------------- PAYM S 1683.88 JLH 02/08/90
TITAN PROPERTIES
PO BOX 6835
ALOHA OR 97007
Phone r#: 6455477
Reg #. . : 30558 ------------------------------------
$ 1723.88 TOTAL
,This permit is issued subject to the regulations contained in the ------- REQUIRED INSPEC
iTigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Gas L
japplicFble laws. All work will be done in accordance with approved Poet/Beam Insp Ineul
(plane. This permit will expire if work is not started within 180 Plm/undslab Insp Gyp B
Nays of issuance, or ii work is suspended for more than 180 days. PLM/Underfloor Rain
Mechanical Insp Water Line Insp
(Permittee Signature: Plumb Top Out Appr/Sdwlk Insp
Framing Insp Mechanical Final
Issued By: Fireplace Insp Plumb Final
w w w W
CITYOFTIOARD �
e:RYOF fl6Ap
COMMUNITY DEVELOPMENT DEPARTMENT \ MOON R
13125 SW Hall Blvd. P.O.Box 23397,liperd, sepon 97223 (503)839Al to \ CO CTION
639-4171 PERMIT #. . . . . . . : SWR90-0039
PRIM. PERMIT #. : MST90-0041
DATE ISSUED: 02/08/90
SITE ADDRESS. . . : 15745 SW 82ND AVE PARCEL: 2S112CC-7500
SUBDIVISION. . . . : LANGTREE ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :7
--------------------------------------------
ENANT NAME. . . . . .
USA NO. . . . . . . . . . :39197 FIXTURE UNITS. . .:
LASS OF WORK. . . :NEW DWELLING UNITS. . :1
YPE OF USE. . . . . :sr NO. OF BUILDINGS:1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : :sf
emarks:
ner: ----------------------------------- ---------------- FRES
--------------
ITAN PROPERTIES type amount by date recpt
PO BOX 6835 PRMT $ 1250.00
INSP $ 35.00
ALOHA OR 97007 PAYM $ 1285.00 JLH 02/08/90
'Phone #: 6455477
Contractor: -----•------------------------
CONTRACTOR NOT ON FILE
Phone 11: S 1285.00 TOTAL
Reg N. . .
------- REQUIRED INSPECTIONS -
This Applicant agrees to comply with all the rules and regulations Eewer 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
aide sewer 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 Signature:
Issued By: —— —
Call for inspection - 639-4175
I
i
CITY' OF TIGARD RECEIPT OF PAYMENT RFC Ne.- ouion,,
CHE0 AMOUNT a 2966.88
NAME: T (Twi PROPERTIES CASH AMOUNT t .00
A 1)D F F-SSa PAYMENT DATE a 02-,08-90
BEAVERTON, OR T7007 KOCK NO/ADDRi
15745 SW 82NO AVE
PURPOSE- OF PAYMENT AMOUNT PAID F(,'P.F'0l;F n17 PAYMENT AMOUNT PAID
BUILDIN13 PERMIT (90-0041) 3.61.00 F,(.UMBIN(; PERMIT
MECHANICAL. PERMIT 39.00 STATE BUILD PERMIT TAX (9%) 26.6;',
PLAN CHECK FEE 24.75 SEWER USA (90-0019) 1.2511.00'l2no.00'
SEWER INSPECION 35.00 STREET SOC 600.n_L)
PARKS SYSTEM DEVELOPMENT CH 250.00 STORM DRAIN SI)c 2°`-0.00
T01#4L i)IiOIJNI* PAID
CITY OF TIGARD PLAN CHECK APPLICATION
CfFYOF, 'SND PLAN CHECK N 2-1c
COMMUNITY DEVELOPMENT DEPARTMENT PE RMIT N /��
13125 5 W N!'5;vd.,P.O.Box 23397,Tlya,d,Ofagon 97223,1503)639 6175 DATE ISSUED
r O
JOB ADDRESS: 'i AX MAP/LOT 9 5/-/e.CC 7500
SUB: � �;; LOT: `7 _ LAND USE:
I' VALUATION:
OWNER SPECIAL NOTES
NAME: Ty Tien REISSUE OF: — �O -ouig
AE)DRfSS; �l'n ��>> �sQ;Lj LAST REISSUE: _
FLOOD PLAIN/
SENSITIVE LAND:
PHONE:
CONTRACTOR APPROVALS REQUIRED
PLANNING:
NAME —,`,� ��,;,.'. _ ENGINEERING:
ADDRESS: -_V--^ — FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
I
NAME :- - - CAL CUL.ATIONS; --_�-_ r
ADDRESS: _ THUSS DETAILS
PARKING PLAN: --�
—___ LANDSCAPE PLAN:
i PHONE. _ OTHER: q 61
CUI`1MFNT5: ��
PERMIT N ACCT N DESCRIPTION
AMOUNT AMOUNT PD. EIAL, DUE
4J1 10-432 00 Hui Wing Permit Fees ✓ /
10- 431 00 Plumbing Permit fees
10 -411 01 Mechanical Permit F®6f ✓ `312
10 230 01 ;;tate Building Tax (5%)
Ile i 1 ci i n(.3
I'lumhing ___._�✓
10 433 00 Plans Check Fee 7) 'r
H u i 1 d i rig
Plumbing
M+r L h � �✓
30- 207 OO Saw,- Connr..c t i cin
30-•444 00 Sewer- Inspection ''�-- -'� "`_--' � 5 ,
s 32
al••440 00 street System Uev Chai,gr ("All) �� ____-- C- U
S2449 00 Parks SysLem Dev Charcle (PDI:)
31- 4'_+0 00 SLurm Dr�airwgv Sysl, 1kvv Chr•g (SSUC) .7
10-230 179 1RFD -
10 230 O6 Washincli on f:uunl y f i rr N1 (9'�X)
10_?20 00 Am4Ar'l./Wu.igc?w+)+jd
lit C N
APPI 11:ANI' :;fG11�I11U01:
Rc+coived Hy ; (late? Received:
■ i�
I
GRADINGILIZOSI )N CONTROL_INE01 ATION
GENERAL CONTRACTOR NAME& ADDRESS: CASIA-II.E NO.:
APPLICANT NAME:AND ADDRESS:
EXCAVATION CONTRACTOR r1 TJI JIGI,,
NAME:& ADDRESS: 'p-.o (-"Q>< '_`
OWNER NAME AND ADDRESS:
TELEPHONE NUMBERS:
APPLICANT: L4 (04{'77 PROPERTY DESCRIPTION:
STREET ADDRESS AND CROSS STREET/LOCATED
GENERAI,CONTR ACI lOR:_
EXCAVA'r,ON CONTRACTOR:
SITE/JOB:
LEGAL DIiSCRII'F10N: (qO 7
24 FIR/ATTER HOURS EMERGENCY TAX LOT NO.:_ •u. 8 � ^cG UD
CO 'A(71`17 R SON,"'TTLE,TELEPHONE: VI SECTION: /5: / `/,,
_.r-.en y' SITE SIZE,ACRES:_
-- i
�— - DISTURBED/WORK AREA,ACRES:
LOCATION&. ADDRESS WHERE SPOILS
LEAVING SITE WILL.BETAKEN SITE RUNOFF DRAINS TO: (CIRCLE ONE)
(NO"FC:m-AmrE'S MAY HE REQl11RI-'D) LATCH-IIASIN) DITCH PIPE CREEK
(CIRCLE UNE) PRIVATE PROPERTY
PUBLIC RIGIT OLWAti'
J:RQ PQN/SEUIMEN'FATl0N QQNMA RL
MINIMUM FSC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DI IRING CONSTRTICFION: FOLLOWIN(i CON')TRUCT lON:
SEDIMF.NTA'110N FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE. AND RESTORE TEMPORARY ESC
PERIMETER RTINOFT CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS ('LEAN AND REMOVE Al.1.SILT AND DEBRIS
COVER PRA(-ACES ENSI IRI'OPERATV)N OF PFRMANT FACILITIES
CONSTRUCTION SEQUENCE ()H I FR
O11IFR _-
PIAN POR EROSION CONTROL PREPARED AND SUBMII'l 1:1)IN ACCOR DAN( I,WFlll-14.01NICAL G1.10ANCE HANDBOOK".
EROSION CONI'ROI,PIAN DRAWING,AS RFQI11RFD.IlnS PLAN CONS1RIA-F1ON NOTES COMPLI71T.INCLUDING EMERGENCY
PIIONF.NUMBER, SCHEDULEJSTAGING FOR INS FALLAI7ON AND RE:MuVAL OF EROSION CONTROI.MEASURES,AND
AITHC At!LF SI"ANDAR1)NUFFS. i
I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS 13CE.SSARY
TO CONTAIN SEDIMENT ON THE CONSTRI I(-I*ION SEI'E.
OWNER S ATTIREt
Al I I.I /.N1 . INAT 1 'n� --�-
1 R F.
OITICIAL USE ONLY
I
RECEIPT DAFT ACCEIyn_-D
Ills NUMBER RECEIVED BY