15770 SW 82ND AVENUE i
i
- 15770 SW 82ND AVE -
TIFAM, CERTIFICATE OF
OCCUPANCY
ClTy0
rCldOfT16ARO VERMI �� M. . . . . . . c M5790-0101
COMMUNITY DE.VELOPME14 T Dlirv*RTMEW \ OREGON
19125 SW Nell Wvd, N 0.Box 23397,r9wd,Orogen 9722 I(603)639-4175 \ WYI E I SSUL D r 01 /25/91
SITE ADDRESSS. . . : 15770 5W 82ND AVE. PARCEL% 2S 1 1 iXC--12`J00
SUED 1 V I S I ON. . .. . a LANGT REE: ESTATE'.) Z ON I NG s R-12
BLOCK. . . . . . . . , . s LOT. . . . . . . . . . . . . 157
:LASS OF WORK. s NEW
TYPE OF USE. . . s SF
OCCUPANCY GRP. a R3
OCCUPANCY LOADs220 4
TENANT NAME. . . s
Ressarkss
Owners ------------------------.,.________...__
TITAN PROPERTIES
PO BOX 6838
ALOHF OR 97007
Phone its 6455477
Contractors
TITAN PROPERTIES
PO BOX 6835
ALOHA h 97007
Phone its 6456477
Fteg #. . l 30:558
Occvparicy of the above referenced building is hereby given, and certifie,'
the compliance with the State Of Oregon Spiecialty Codes for the group,
acctrpancy, and use under, which the referenced
perer,it was issued.
C.7i —-
FIRE DEPARTMENT BUILDING I CTOR
RU DING a ICIAL
POST IN CONSPICUOUS PLNCL
INSPECTION_NOTICE
City of Tigard Building Department
13125 SW Bell Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FILL
Post/Beam Struct. San. Sewer Framing *181.1d
Post/Beam Mech. Rain Drain Insulati,,n
Plbg. underfloor Water Line Gyp. Bd.
Dat-.e Requested:_ l/ ill._.! Time: _ AM t _PM
Address:_ ? J it _ Permit #X /' ''0
Builder
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector:_ i—` Date:
_—APPROVED - DI9APPROVgO _- APPROVVV SURJECT TO ABOVE
Call Por Roinsp.
INSPECTION NOTICE �\l�
City of Tigard Building Department Y
131.25 SW Hall- Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buaine3s Phona: 639-4lU
Inspection—
Footing Plbg. Underal Hoch. Rough-in Appr/Sdwlk
Four..d. Plbq. Top Ou Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Inaulation -Plvmb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested:_,�Q�� _.._-._TL-= PM
Addreea:_ ...____ 1 y �� (� - _ Permit K:
Builder:
f _
THE ro-LOWING CORRECTIONS ARE REQUIRED:
G2 i A -
— --- s
Inspector:i� / _ Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
-Call For Reinep.
� a I� � � �Ir �► I■r
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 �.�.
Phone 639-4175
r
Type of Inspection
Date Requested_-. Time r_A.M. P.M.
Address _, Pertnit .W-
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Prescuted to
Inspector ��{�'�_ ! 5— ❑ Disapproved
Date -
/ CALL FOR REINSPECTION
❑ yes %kVe ,
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97773
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspect ion:
Footing Plbg. Underslab Mech. hough-in ppr/Sdwlk_
Found. Plbg. Top out Gas Lire FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beata Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Li:..,i Gyp. Pd. -Mech.
R .-
Date
equested: f� &/t �& ,`Time: AN G.�,FM
Addrena: 7 10 00,?- Ad _ hermit
Builder:
TU FOLLOWING ODRRECTIOi9 ARE REQUIRED:
14
tl
Inspector: L t- / / Date:
APPROVED Ia"PAMtLMPR_OVED StleJECf TO ABOVE
11 Por Retnep.
INSP1TCfION NOT1. E
City of 'Tigard Building Department
13125 Sit Hall Blvd. Tigard, Oregon 9722
inspection Line (Rec-O-Phone): 639-4175 Duaineas Phonea 9-4171
I•' IpectIon:_ --
Footing Plbg. Undersiab Aech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lin FINAL:
Post/Beam Struck. San. Sewer Framing -Bldg.
lost/Beam Mech. Rain Drain Insulatio\n -Plumb.
S.lbg. Underflocc Water Line (--Gyp. Bd. 1 -Mech.
Dots Requeeteds_ _y ` �1Q Timet
Xddreea: 5-770 d Permit #s
Builder:
-ME FOLT.OWIIIG 0DRRECTION8 ARE RROUIREDt
Inspectors
1 AppROVvD DISAPPROVRD APPROVED SUB.TECT TO ABOVE
��7TT"'"'--- Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oragon 97223
Phone: 639-4175
Type of Inspection =— - —
Date Requested_ �� 3 '� Time—,4. A.M._ P.M.
Address _---� � rJ d --- Permit #
owner . _.__
Lot
Builder
'i he following Building Code deficiencies are required to be corrected:
Presente i to — Approved
Inspector _ ❑ Olapproved
Date
CALL FOR REINSPECTION
FA YES ❑ NO
� � '� 1� l� Si! '4► �
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175 _.._
Type of inspection a.�G.23 ___--
Date Requested—__ 77 �Q Time_— A.M. P.M.
Address /.5�1_U s l --__ Permit #6�-
i
Owner-- — — — Lot #-------- — �_ i
1
BuilderThe following Building Code deficiencies a quired to be corrected:
i
Presented to -Approved
lnspecl Disapproved
Date
CALL, FOR REINSPECTION
Cl YES (_] NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, O.egon 97223
Phone: 639-4175
Type of Inspection _ ` /tet-L __--_ _
Date Requested__,4 —Z a ~ '5wO _ Time __'� A.M._ P.M.
Address __5 2 71,x___? _____.-- Permit # 10 A��
Owner--- -- -_--- -- -- Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to `Approved
Inspector C_� Disapproved
Date
CALL FOR REINS EC t
Cl YES 0 NO
INSPECTION NOTICE
City of "figard Building Department
P O Box 23397
Tigard, Oregon 9722.3
Phone 639-4175
Type of Inspection --__ � _
L� '��_ �2Q�
Date Requested__``L13 -- me X' A.M. �j--P.M.
Address 1.�� � a _— Permit 1;0
Owner _ // Lot �k
Builder
The following Building Code deficiencies are required to be corrected:
-of12)
Presented to (] Ap
Inspector eloDisapproved
Date
CHAT FOR R INSPE( TION
El YEs ❑ No
■
INSPECTION NOTICE
1
City of Tigard Building Department L A"
0.0 Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested . ��`� Time A.M. P.M.
Address �� �Q � Permit #���
Owner ,_ _ Lot #
lC:err F
Builder —`
F-
The following Building Code deficiencies are required t3 be corrected:
s
Presented to �'�� --- — _ Approved
r�
tnspeuwi Disapproved
� ----
Date —
CALL FOR REINSPECTION
❑ YES ❑ NO
WASHINGTON gblk�TY, NSPECTION CARD Project No_
I DEPARTMENT OF LAND USE AMC) TRANSPORTATION PERWT NO.
t` FOR INSPECTIONS CALL: 640-3561 , 24 HOURS --
FOR INFORMATION CALL: 640-3470 DATE
ADDRESS � � • '�!,�, r �
` PERMITEE
DIRECTIONS ` �'> -
--- ----- / PHONE N0.
i
":SPECTIONS: ❑STRHCi �K(H EIELEC1
CALLED IN BY
APPROVED. � /h
]REOUESTED INSPECTION APPROVED
HOWEVER -NOTE •:�
Pl APf>ROVEa.
ILIREPAIR OR REPLACE AND RE-INSPECT:
STOP WORK UNTI El
INSPECTOR
n 1
WASHING Project No
00ft;;:z, TON COUNTY INSPECTION CARD
DEPARTMENT OF LAND USE AMD TRANSPORTATION PERIAIT NO.
FOR INSPECTIONS CALL: 640-3561, 24 HOURS -r
FOR INFORMATION CALL: 640-3470 �
ADDRESS1 PERM1TfI
I
DIRECTIONS PHONE Nu._._
':SPECT IONS: RUCT LIMB rMELH FiELECT
' ,• CALLED IN BY
APPROVEm
aHOW[VEP
REQUESTED INSVECTION APPROVED i NOlt :
NOT APPROVED:
L---)REPAIR OR REPLACE. AND RE-INSPECT: ' --
(STOP WORK UNTIL: /� -- ---- - - -- -- - --
-- /C,�TL C/ - ------- -
INSPECTOR
� ( 1
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ._—_ �' ' 1L-------- -- - -- --
Date Requested
Time x A.M. P.M.
Address _J _f 1� —..5 W Permit
Owner _ _ Lot #
Builder _�------- ----------
The following Bui+ding Code deficiencies are required to be corrected:
1�3 Py lLLG,,
Presented to _—__ Approved
Inspector � '� LI Disapproved
��/
Date __.vZ1 .�C/,�
CALL FOR REINSPECTION
El YES IJ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested � `�� �U Time A.M._ _P_.M�.��,
Address 115- 1776 f-l� h -�' Permit
Owner .-__. Lot #_
Builder
The following Building Code deficiencies are required to be corrected:
Presented to -. -_-___ .__ Approved
Inspector '_ 3 _ __ � ( Disapproved
i
Date i
FALL FOR REINSPECTION
C] YES I--] NO
CITY OFTIFARD MASTER PERMI-r-
CITYOFTWA PERMIT MS
COMMUNITY DEVELOPMENT DEPARTMENT ;)Tgo oto,
gem
13125 SW HWI Blvd. P.O.Box 23397,Tgad,aegon 9722p(�03)11?"I,76 OR 1"'RI M PE RMIT #. - MST90-0100
DATE ISSUED: 06/27/90
1".J ('/0 bW 62ND AVE...
`3UBDIVISIC)lq L.I.-INGTRE-E PARCEL: 2S112CC-1250e)
k.'ILOCK. ZONING:
L-0.... . . . . . . . . . . . . :57
Ef U 1:1 DING -
REISSUE:90-0058/6A DWELLING UNITS: 13
(-"IBASEMENT. . . . . . . . ..0 4 S f
(:,i_.ASS S S 0 F W 0 R K,. -NEW BLDRITIS.3 BATHS:7 GARAGE. . . . . . . . . . UOOO 5 sf
TYPE OF' USE:- - .. -SF FLOOR AREAS-__ REQUIRED SETBACKS-_
TY 1::'E 0 F' C 0 11 S T. '.5 N F*IRST11 . . . g5J. 6 Sf LEFJ. . .'02 ftRIGHT. :03 fl.
OCCUPANCY BR;:'. :R3 SECOND. . . :40:40 sf F'RONT. :oy
STORIES. . . .. . . . :2 f t REAR. . :111S f t:
TH I R D. . . . :0 13 s f R E 0 U I R E D
1 GH 7. . . . . . . . ..20 ' ft S", SMOKE DETECTORS. :T
FLOOR LOAD-, - . . :40 psf V0J..UE. . . . . qj: 6«5622 PARKING Sl-.IACE:S. . .*l
ReniarEtsa.
---
!3 IN K S. . . . . . . . . . .
.2. FLOOR DRAING. . . . go
I AW'ITORIES. 31 BACKFLOW PREVNTRS. . :
WATER HEATERS. —, . 1 TROPS. . . . . . . . . . . . . . .
TUD/SHOWE."RS. . . ,. : 1.1. LAUNDRY TRAYS. . . :
WATECATCH BASlNS. . __ ._
R CLOSETS. .0 SEWER LINE :00 GREASE' TRAPS.
DISHWASHERS. . .. .. -. 10 WATER (ft) . go 0 OTHER FIXTURES.
GARBAGE DISP. .0 RAIN" DRAIN (ft) . - to
WASHING ':)I:' RAIN DRAINS. . -
...... .. MECHANICALF E
FUEL TY P ES UNIT HTRS. . :0 type ArnatAiit by date -r e C,r.)t
S/ V LN TS . . . . . :31 PAYM $ 40. 00 J L 1.4
MAX INPUT:01.00 T U VENT F-ANS. . :01. 11 P-,RT $ 331.00
1::1.)RN < :1.00K g.0 HOODS. . . . . . :0 B P,L C $ 40. 00
FURN >t--:1W0K .0 WUUDSTOVE'S. El III*";P,C $ 1.6. 55
F] 0 0 R F'U R N. . . . CLO DRYERS. STDG $ 600. 0W
BOIL/CPIP < OTHER UNITS11 93 S D C $ 2j0.00
GAS OUTLETS:3 PARK $ 250. 00
Owiler: .........––– PARK $ 250. 00
TITAN PROPERTIES MPRT $ 1,36. 00
PO BOX 683,S
11 P,L.C 9. 00
1-11 L)HO OR 97007lyl516 1. 80
P1.101-le 0: 6455477 t 1.32. 50
P5PC $ G. 63
t T,a(�t or t ........... PA Y 11 $ 1883.. 48 JL H 06/c"*-? 9 0
fl.' 14)N PR 0 P E RT I E 9
PO BOX 6835
PLOP-10 OR 13. *100'7
1:11 Ile #: 6456477
This Permit is issued subject to the regulations contained in the 1923. 48 TOTAL
REQUIRLD INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other 1"0Ot/f0Lt)-1(1 11-ISp Mechaiiical 111sp
applicable 16041. ,ll work will be done in accordance with approved Wtr Proofil-Ig Bsm Plt.tmb Top oL,t
Plans. This permit wall expire if work is not started within 189
days of issuavmgf or if ark is s Post/pearn 111sp Framing Insp
uk� ed fo 190 days. Crawl Drail-I F ireplace
11'errn:ittee IRsIn' t Slab Gas Lj,iie Inrcrt
--------- Plni/t.iiiderslab in 1,
issued Ery- PLM/(-)iic1erf Ion.(, Up
YP Board 111sp
......... Draj.il Bsnit ryain111sp
--------------------- 639 41 /5
SEWLR CONNE'C"HON
CITY OFTIFARD 1-1 E R 1YI I'T'
Cff Y LARD PERMIT' 0. . . . . . . .. SWR90--0.109
COMMUNITY DEVELOPMENT DEPARTMENT ORR
13125 SW Hell BW. P.O.Box 23397,Tigroid,Oregon 97223 75 P,R I 1YI, PE R 1111' # 11 G T 9 0 _01.0 1
- r., J DATE. ISSUED: 06/27/90
S11'E ADDRESS— . -. 15770 SW 82ND AVE PARCEL: 2S112(.1C,I.2!�,00
SUBDIVISION. . . . : LANGTREE ZONING:
BLOCK. .. . . . . . . . LO'T. . . . . . . . . . . . . :57
TENANT NAM-:. . . . .
USO NO. . . . . . . . . . „.41630 FIXTURE UNII'S. . .
C-1-ASS OF* WORI"%.. . . -HE*W DWELLING LJNI.'T*S. .
'T'YK'E OF USE*. ., _. _-SF NO. OF BUILD1NGS:1
I NS T A L L T'Y F-F'.. D UI ,:;W P, IMPERV SURFACE. . f
Renla-rks 4
Owrie-rt
117*A N P R 0 P E R T I EE S type aniat.mt by date -r e c:r)t
PO BOX 68..35 PRI11* $ 1250.00
A I OHA OR 97007 INSP $ 35. 00
1:11-imie Oc 645t--)47*? PA Y 11 $ 128::,. 00 JLH 06/27/90
CONTRACTOR NO'r ON F'ILE
$ 1.285. 00 T'(]T'P
R E 0 UI R E D INSPECTIONS
'his Applicant agrees to comply with all the rules and regulations Sewer l)-i!apeetioll
of the Unified Sewage Agency. The pewit expires 128 days from
the date issued. The total amount paid will be forfeited if the ........ ......
I)ermit expires. The Agency does not guarantee the accuracy of the ......
:,Ap 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. ........
......... ................
ISSUFNI By:
................ ................
Ca.11. fa-r inspection --- 639 4175
mu
,--ITY OF' TIGAPD PECEIPT (W PAvrif-wi REC,'E,rF,r tio.
'TITAN PROFSPTICS AMOUI\17
CASH AMOL114T
PAYMENT DATE
ALOHA. or? SUSD V)15 1 ON
j" 7 C) SW �3."-:'N v A,,,)c
1-`l.-lF`1='O3E- OF. PA Y'MENT AMOUNT PATD PUFPOSE.. nF' PAYMENT AMOUNT PAID
BUILDING PERM 1 . Of., PLUMBING PERM
MECHANICAL PE 36,00 ST. BUILD PFR
PLAN CHECK FE SEWEP IJG�) 24. 98
SEWEP, INSPECT 35. STREET SDC 14-03o.oo
f-.Apft.,,s srr, 250. oo STORM DPAIr,l 3L)C: 600.00
250.00
A1101_►NT PAID 2;' l Ei. 48
CITY"' /
1'
c narlWW PLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT \ PLAN CHECK N -
13125 S W Hall Blvd.P.O Box 23397,Tigard,Oregon 97223,(503)fi3g-AI?5 PERMIT N
1 DATE ISSUED
/JOD ItESS: _ - O TAX MAP/LOT _
;UD: XLOI; _�2 _ ^ LAND USE: -
1L
1VAl_UAI [ON:
C►WNER � - -- -` ! - - SPECIAL NOTES
IN-t-
REISSUE OF /U` f- 90 - p S 3_-
ADDRI SS;� �� LAST REISSUE:
FLOOD PLAIN/
I IONS: t - - -- SENSI T tVL LAND:
P _
__�
APPROVALS REQUIRED
CONTRACT_OR� A- - — PLANNING: _ --
NAME: _ - '�`�__ ENGINEERING:
ADDRESS: - VIRE DEPT
OTHER
PHONE: _ _ ^ _ ITEMS REQUIRED
BUII-DLRS BOARD iy: _ -�_ - _ EXP DATE: -2 - �b Tr LIST/SUBCONTRACTORS: _
BUS TAX: _
ARCH/ENGINEER CALCULA(IONS:
NAM[ _ _ _ _. TRUSS DETAILS:ADDRESS: -_--- - - -� OTHER:
PHONE:
COMMENTS:
:;UBC:ONTRACI ORS: PLUMB� ? _�, - f/ _ MECH: j��,� r;. - �0
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. DAL. DUE
10-432 00 Building Permit Fees / ' 3.31
10-431 00 Plumbing Permit Fees /j,l.J� /—IL'ST
10- 431 01 Mechanical Permit Fees.
1( -230 01 State Building Tax (5%) y qy
Building /� • � � -
Plumbing �• (0 3
Mech
10-433 00 Plans Check Fee -1/Z) ` 2
13ui lding -
Plumbing
Mech c
30-202 00 Sower Connection x.5(1 / L S2
30-444 00 Sewer Inspection _ T11-
51-449
jT51-449 00 Street System Dev Charge
52-449 00 Narks System Dev Charge (F'DC) S--v
31--450 00 Sturm Drainage Syst Dev Chrg (SSDC) _ ? rU
10--2�0 06 F ire _
TOTAL qv
APP TCAN" SIGNATURE
Received By: - __.. Date Received:
cn/3501P/18P
GIZAD1NG/EROSION CONTR )I. INFORMATION
GENE-RAI,CONTRACTOR NAME& ADDRESS: CASEFILE NO.:
_ 4'J ,. (I- PERMIT NO.: --
1d �p — APPLICANT NAME AND ADDRESS:
EXCAVATION CONI-RAC-FOR _ -ITAtJ PRcr- 1") i�
NAME& ADDRESS: "lp 4• Rox `—
li/'�41ti1 nLc.iAN, CUL 9 100 '1
OWNER NAME- AND ADDRESS:
TELEPHONE NUMBERS: —
APPLICANT: c- u-7- +1'r'I' _ PROPERTY DESCRIPTION:
OWNER: I ' 1'% i _ STREET ADDRESS AND CROSS ST R /LOCATED
p GENERALCONT'RACTOR: •( ' '/' I IXY.
_
EXCAVATION CONT'RAC'TOR: (ale 2 _ nLl��)
i SITE/JOB: _
LEGAL DESCRIPTION:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
CO ACT PERSON,'['ITLE,TELEPHONE: 1/4 SECTION:
c�•Y\ �i' VN P Y SITE SIZE,ACRES;
-L a- I Lf'--- -_
DISTURBED/WORK AREA,ACRES:
LOCATION& ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS TO:(CIRCLE ONE)
(NOTE:111-RMIT'S MAY BE REQUIRED) (CATCH-BASIN DITCH PIPE CREEK
I
(CIRCLE ONE) PRIVATE PROPERTY
E'U LLQ RIGFIT OF 1VAY
EROSION/SEDIMEN'T'ATION CONTRO 'Ea )MEAL IBES
MINIMUM ESC REQI III?I-MF:NTS MINIMUM ESC REQUIREMENT'S
H WING CONS1141)C11ON: FOLLOWING;CONSTRUCTION:
SEDIMENTATION FACII TIIF1 S STABILIZE EXPOSED SURFACE
STABILIZED CONSTRIK'TION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMI TT'R RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER 1'RACI'ICI:S ENSURE OPERATION OF PER MAN I'FACILITIES
CONSTRUCTION SEQUENCE OTHER
O'1'I I L*R ---
PIAN FOR EROSION CON•IAOI.PREPARED AND SUBMITTED IN A�'CORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK".
FROSION CONTROL PIAN DRAWING,AS HLQUIRED,HAS FLAN CONST'RUCI'IC'4 NOTES COMPLETE,INCLUDING;EMERGENCY
PHONI:NUMBER, SCHF.DULFIS'TAGING FOR INSTALLATION AND REMOVALOF EROSION CONTROL MEASURES,AND
APPLICABLE STANDARD NOTES.
1 HAVE:R"D AND WILL COMPLY WCI'H THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
Fu CON'T'AIN SEDIMENT ON TIIF CONSTRUCTION SITE.
*
i OWNFRR S�IRi-
APPI.I A NATURE
01T ICIAL USF ONLY.
RECEIPT DATT- ACCEPTED
Fl F NUMBER RLCEIVF.1) BY