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13327 SW SCOTTS BRIDGE COURT — 13327 SW Scotts Bridge Drive — a� 0 Q) Im 10 01 V) 0 U U) N r- -4-I 1 jN13PECTI0N NOTICE: City of Tigard Buildiag Department 13125 8li Hall Bed. Ts,jard, Oregon 97223 Inspection Line (Rec-O-Phoq,6) . ,639-4175 Buoineas Phones 639-4171 Inspection: _ L _� :--------- -- Tdrerelab Mech. Rough-in Footing Plbg. 16h % round. Plbg. Top Out Gas One FINALt pest/Beam Struct. San. Sewer Framinq -Bldg. Foot/pv wn Mech. Rain Drain insulation --Plumb. Plbg. Underfloor Nater Line Gyp Bpi. -Koch. Date Requested: Timet AM PM Addresst 1 3 3 27 a {_Permit TNS FOLLOWING CORRECTION8 ARE 11WIMUt Inspect,n : _ � >`a�`tiL� Lf 6 ------ Date: APPRMD DISAPPROVRD / APPROVED SUBJECT TO ABOVE call For Minap. - --- CEi;TTFICATE: OF' CIIYOFTIFARD OCCUPANCY I '7�F7 lel•=RM I T M. . . . . . . a MST90-0138 COMMUNITY DEVELOPMENT DC,PrQ1�i. 13125 SW Hall Pled. P.O.Box 23397,Tigard,Oregon 97 ( � '14-ITIS PATE" I S S UE D e 11/13/90 SITS:. ADDRESS— . $ 13327 SW SCOL Tti DRIDUL DR PARCE:Ls RS194AH 03:300 SUBDIVISION. . . . a MORNING HILL NO. 3 7.ONIN(3s R 4.5 BL.00K. . . . . . . . . . a LOT* . . . . . . . . . . . . 166 CLASS OF' WORK. eNEW TYPE OF USF. . . sSF OCCUPANCY URk. sR3 OCCUPANCY LOAD a 22 0 4 T E_NAN'T NAME. . . e R 0"10.e(,k.e+ e Owners WT;DGEWOOD HOMES 13250 SW FALCON RISE: DRIVE T IGARD OR 97223 Phone #a 5032923563 Contractors WEDGWOOD HOMES 13850 ,W FALCON RISE:: DRIVE 1113ARD OR 97223 Phone Ns 5032923563 key N. . a ;3338 I Or..cur)Ar)c:y of 1„' a above! -rer. fearesnced bieildinp its hrrebr and certifies t:h1'ee r.omplia►nch with tha stat—,p. ()f (Trepan Spmet&I.t;y Codf,i ff,,r thw group, 0rrtApanc!y, and use under whi,_h the T91'erenved F)vrm.lt was iusurd. F IRE: DEPARTMENT ILDINO Y hpPECTOR PUI INO O ICIAI_M__ POST IN CONSPICUOUS PLACE -PECTION NOTICE City of Tigard Building Department 1 13125 SW Ball Blvd. Tigard, Oregon 97273 Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171 Inspection:--.�—_----- -- ---- --------------- Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out. Gas 1.1110 FSNALt Poet/Beam Struct. San. Sewer Framing ldg. Poet/Beam Mech. Rein Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Koch. Date Requested: _.—__TLmet /Z=AN PK Addresst Kwlt t Builders THE FOLLOWING OOROCTIONS ARS REQUIRED: i �J Inspector: —_.... _ Datet APPROVED 4"71PPROVF.D SUBJECT TO ABOVE Call For Roinsp. INSPECTION NGTICF. City of Tigard Building Department. 13125 SW Ball Blvd_ Tigard, oreqon 97223 Inspection Line Rec-O-Phone): 639-4175 Business Phonc: 639--4171 Inspection:_—� --- Footing //� Plbg. Underelab Mach. Rough-in Appr/Sdwlk C Found. Plbg. Top Out Gas Line FINAI.t / Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rhin Drain Insulation -Plumb. Plbq. Underfloor Wator Line'l Gyp. Bd. -Mach. Dat.F. Requesteds.. N -- - �v Time: --AM (/PM Addresst / J� 7 i' „�J vi'. �t--t•r�--"�-+sa-- Builders — THE POLLONINO CD CTIONS NRF. REQUTRED: inspectors _7j Dates 21 APPROVED DISAPP/ VRD _ APPROVED SUBJECT TO ABOVE Call For Reinso. INSPECTION NOTICE City of Tigard Buiiding Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection ��7 Date Requested —`r 1 Time A.M. P.M. Address '' Permit # Owner --- Lot # BuilderThe following Building Cc4,e deficiencies ere required to be corrected: Presented to ])Approved Inspector Y l ❑ Disapproved Date -- CALL FOR REINSPECTION C-7 YES 4 NO HISTORY: VIEW UPDATE DELETE ESC View comments for selected item O&MASTER PEItMITii&&&&&Sa&a&b&SSSASSSfiaaaaaaaSfiaaSSSSaaaSSSfiSaSSaaaafiSSSSaaaaa&SG :MST90-0138: PROJECT:MORNING HILL STATUS:F : UPD:10/22/90: :MRS: PERMITTEE:WEDGEWOOD HOMES PRIM. . :MST90-0138: SITE ADDRESS:.13327 SW SCOTTS BRIDGE DR " Hifi CASE HISTOT'Y ASSfiSSS&fi&&&A&&&&&fiSSAAaReq/Sent&Schd/Dile&End/Done&&By&Stat&&AC A705 Foot/found Insp 05/16/90 KS APP A707 Wtr Proofing Bem•t Wills iO0'C' p 4t:P Jb P ° A710 Post/Beam Insp 06/04/90 KS APP " A713 Crawl Drain A73.5 Plm/undslab Insp A717 PLM/Underfloor A718 Ftng Crain Bgm't Walls A770 Mechanical Insp A722 Plumb Top Out 08/10/90 MS PASS ° A72.5 Framing Insp 08/28/90 KS DIS A726 Framing <REINSP> 08/31/90 KS APP ° A730 Fireplace Inap OR13f/90 145 Mary A"735 Gas Line Insp 08/28/90 KS AFP ' A740 Insulation Insp 08/28/90 KS APP A745 Gyp Board Insp 09/11/90 KS PART SASASSSfiSa&55555555&fiSSaa5553555aaSSSSSSaaaa55555€�aSAaaaaaSS.�aSfi&555ASSSA&Saa;li INSPECTION NOTICE City of Tigard Building Department P.O 3ox 23397 Tigard, Oregon 97223 Phc ne: 639-4175 Type of inspection �•-�.�� � 4 +�C~--� Date Requested ' — Time . A.M. 11 nn Address _,l 3� .rd�EZ / Permit Owner_ _�._ _ t-ot #_ Builder --- The following Bui ing Code deficiencir required to be corrected: I Presented to 4 sZ2 _ pproved Inspector ___ .G ❑ Disapproved Date CALL FOR REINSPECTION ❑ YES ❑ h0 ■r �f � a INSPECTION NOTICE City of Tigard Building Department UUU P.O. Box 23397 / Tigard, Oregon 97223 Phone: 639-4175 / Type of Inspection Date Requested �� Time �q.M. _P.M. n n'x� Address /-2 aA.;1" -7 z �'Perrnit #J� Owner Lot Builder The following Building Code deficiencies are required to he corrected: Pro-tented tof1T Approved Inspector __��%_!_ __.__ ❑ Disapproved Date CALL FOR REINSPECTION ❑ YE8 ❑ NO W W1Wff1WW-KWX1 INSPECTION NOTICE City of Tigard Building Dr, -tment P.O. Box 23397 Tigard, Oregon 97223 Phone: 6394175 Type of Inspection `-- Date Requested—--- f ' l Tim A. P.M. Address Owner_ C Lot BuilderThe following Building Code deficiencies are required to he corrected: `1 (� ?Sc/L"I 7 v�.y�. �1�c`:,�/��.�,�,7. �✓CF=rte cam_ / ❑ Presented to Approved raved IQ Inspector ! ❑ Disapproved Date CALL FOR REINSPECTION 0 YES 0 NO � O t INSPECTION NOTICE r. City of Tigard Building Department G P O. Box 23397 Tigard, Oregon 972.23 Phone: 639-4175 ' 9 Type of Inspection —x �� Date Requested �'�` _ Timr7&2M-1;1-----P.M. Address --- f 7 % J`I srmit #k Owner Lot Builder_L ,—X25 The following Buildin Code deficiencies are required to be corrected: i Presented to Approved Inspector LI Disapproved Date CALL FOR REINSPECTION ❑ YE-0 ❑ NO INSPECTION NOTICE City of Tigard Building DPhartment P O Box 23397 i JTigard, Oregon 7223 Phone: 639-411 75 Type of Inspection Date Requested Time -A.M. P.M. Address�3 2i=4 - Permit - i v Owner_ Lot # Builder The following Building Code deficiencies ars required to be corrected: c=S-- Presented b _ pprovsd Inspector / e I Disapproved Date 2 CALL FOR REINSPECTION1 C YES El No i 'i INSPECTION NOTICE City of Tigard BmIdinq Department P O. Box 23397 Tiqard, Oregon 97223 Phone: 639-4 175 C� Type of Inspection Date Requested Ti P.M. P.M. Address - �� `7 /- -7.� ~fir C/ �.PArmlt Owner. Lot # Builder The following Buildind Code deficiencies are required to be corrected: - - -_ L_)u Presented to _ `�I -_� pprov#d Inspector � Disapprovtd Date � "L.� '� L CALL FOR REINSPECTION ❑ YES 9XIO PAFff—IN INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested Time A.M. P.M. Address ���.� _ � Permit # Owner / f' -✓— Lot #_ Builder The following Building Code deficiencies are required to he corrected: i r i l V7Z �L n✓ presented to �/Approved Inspector Inspector L_-I Disapproved Date _ CALL FOR REINSPECTION YES O NO CW W or INSPECTION NOTICE ., City of Tigard building Department P.O. Box 23397 Tigard, Oregon Phone: 639-41 t5 /J Type of Inspection -1 �(f'l-> 2�(/ a Date Requested — Time A.M. ="'i P.M. Address Owner j— "Lot # Builder The following Buildingod�iencies are required to be corrected: --- low Presented to - _ Approved Inspector /� i Ll Disapproved L Date U CALL FOR REINSPECTION ❑ YE8 0 NO I INSPECTION NOTICE_ City of Tiga,d Building Department P O Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection Date Requested P.M. Address Owner Lot # Builder The following Building Code deficiencies are required to he corrected: IA-` ^-,'d7 :P Presented to -- _ —_ I Approved j Inspector Disapproved Date CALL FOR REINSPECTION 0 YES ❑ No RW W s Wjff1 M WJEWIP INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 ' Phone 639-4175 Type of Inspection16 --- Date Requested_._-.�[_._ Time - ----- A.M. P.M. Address _� S.Z .ZZ_ ---����� --- Permit Owner- _ ---- ---- - -- Lot # Builder _.__� � • rr• --_..-------- _ The following Building Code deficiencies are required to be corrected: Presented to "�npproved Inspector _ [] Disapproved i Date CALL FOR REINSPECTION ❑ YES CA NO I r W t I , I i J INSPECTION NOTICE .� City of Tigard Building Department F.O. Box 23397 Tigard, Oregon 97223 I GFnone/ 639-4175 'type of Inspection � -------- Date Requested_-__ ��//// ,,.. Time A.M. P.M: Address 1_s � /� �� ) �L�_ &ermit Owner _ Lot Builder The following Building Code deficiencies are required to be corrected: c Presented to 1 Approved Inspector _ l' C� [� Disapproved Date - CALL FOR REINSPECTION C-1 YES I NO CITYOFTIFARDMASTER PERMIT CITYOF RD P,E'RIII IT #. . . . . . . : MS'T'90....0138 COMMUNIYY DEVELOPMENT DEPARTMENT oRaoN PRIM. PERMIT 11. : MST'• 0--01 38 13125 SW Hell Blvd. P.O.Boz 23397,Tipad,O Wn 97M JOW)P?"}76 DATE: ISSUED: 05/01/90 SITE ADDRESS . ,. . :: 13327 SW SCOTTS BRIDGE DR PARCE::LI 2S104AD-0:3'. 00 [ SUBDIVISION. .. ,, . ,.- MORNING HILL N0. 3 ['[' ZONING: R--•4. 5 BLOCK.N M Y Y N . n ,, ,, . I 1...U'T . . . . . . . . . . . . . :66 y _.._........_..._ __....__.._. .. .__... _.._...___....__.._....—... BUILDING _... ._.._.__.._._.__.__._.._.___...._._._..__.._._.....____._...___..__......._...._.... RE:T.SSUE: DWELLING UNITS: 1 POSE:MENT. . . . . . N . :0 sf CLASS OF WORK. :NE:W T.4E-DRIII S.2 11A'T'1.1S.2 GARAGE:. . . . . . N . . . ::.380 s f TYPE OF USE. . . .SFFLOOR AREAS—­­­­-­­ REOUIRE:D SETBACKS—­­­­­­ TYPE. UF' CCINST. �rN FIRST'. . . . .. 1.184 1. f I_.FEFT'. . :5 ft DIGHT. -5 1't OCCUPANCY GRP'. :R3 SECOND. . . :300 s f FRONT. I r",,.0 ft RL ARN . 128 ft STORIES. . . . . . . ..0 THIRD. . . . :0 1. f REOUTI;LD—-----------_.....__._.__....__......_....... FIEIGHT'. N . . . . . . :20 ft f SMOKE DETECTORS. IY F LOUR LOAD. . . . -40 ps f VALUE.. . . . . $. 69168 PARKING SI'ACE:S. . :O Piema'rI•r.�I .__......._...__.__._._._..._.._.._..._._ _..__._._ PI...UM14ING •_.__...._.,...__.__._.._.._._.____..._.___......._........_._.__._....._....._._.__.. LINKS. N . . . . . . .. . : 1 FLOUR DRAINS. . . ., r,0 BACKFLOW PREVNTR,,3., . :0 I...AVATURIES. . . . . :2 WATER HLAT'ERS. . n r I. TRAPS. . . . . . . . ,. ,. ,. , , .. :0 'TUB/f:)HOWERS , . . . :r? LAUNDRY 'TRAYS. „ . ::0 C A T C I I DASINS. ,. ,. „ „ „ „ 0 WAT'E'R CLOSL'TS. . :c Sk WE.R LINE: (ft) . -0 GREASE TRAPS. . n . . . ,. 0 DISHWASHERS. . . . .. I WATT.::R LINE. ( ft) . : 100 OTHER FIXTURE:'.:)., „ . n „ ::0 GARBABE' DISP. . . 11 RAIN DRAIN (ft) . :0 WAf31.11:NG M0CIA. . . : 1 SF 80114 I)R01:N::i. . : 1. .........._....- _._.._._.._ M E C H A N I C A I_ ......._._._..._.._._......_.._....._..... __.._........._._......._ .M........_ .._ FEE::S ....._._....._..__._._.......__.. ..._ i UV.I... 'TYPES- - -- -................ UNIT HTRS. . :0 tYpe <aIn0UI'lt by (I ate •rer_p•(. /GAS/ / / VI-.N113. . . . . . ...H PAYM $ 200.00 3LH 04/26!90 200397 IMAX TNPU'T':0 F:rTLI VI'::N'T f:'ANS:. . :: 1. BFIRT' $ 34;3. 00 ! / F URN � 100K . . - I HOODS. . . . .. .. -. 1. EIPL.0 $ 222. 95 F URN )=400K . . :H WOUDST0Vf::::>. :0 85FIC 1; 17. 1.5 FLOOR FURN. n . . :0 CLU DRYLRS. : 1 STDG $ 600. 00 Xi0l:l_/C11P < IHFI:O OTHER UN 1:TS.-O SSDC $ 250. 00 CTAS OLITLETS: 1 PARK 1; 250. 00 ()wner: __._._._....._._.__._.._.._..__.—_........_........__..............._.._......_..__.._.. MPRT $ 30. 00 WLDGE:.WOOD HUMLS MPLC $ 7. 50 1.;3r.:?50 SW FALCON RISE:' DR I VI: 1151-1( 1; 1.. 50 PPRT $ 1.17. 50 T I GORD C)R 9 /G?2 3 I-'C'!I"'C: $ 5. 87 F!hrarle b: 5032923563 PAYM $ 1(.14,`'1. 47 KILL 05/01./90 C;c3ntr,actar d ••---•--_................_.........._............._......_....................._.........__...._ WE::I)(:)E::WU(:)D HUME:S 1.;3(.?',*50 SW I'lGARD UR 97223 Pharie 9: 3032923563 ReqN., ,. n 1-333E1 _._....._...__..._._..__....____...._..__.___..._____.....____..____..._....___.. $ 184;:1. 47 'TOT'AL This permit is issued subject to the regulations contained in the --- -- RE'QI.IIRE::D INSPECTIONS --- --- Tigard Municipal Code, State of Ore. Specialty Codes and all other Faot/found Instp F'It.nnb 'TOP Out applicable laws. All work will be done in accordance with approved Wtr• P-roof inq Bsm F •raminq Insp plans. This permit will expire if work is not started within 188 Fast/Beam Ing fa F i.replace Insp days of issuanco, or if work is suspended for more Chap I days. Crawl 0-raii7 Gas L..i.ne Insp P1m/t.rri(JsIab Ingp InaUl,at:iari Tri sp f'ermt:ee f:)i.gnat�.�rea •- e �2 s% PLM/Unraerf1.aar Gyp Berard Insp it ` -��^�� F'triq D•rAi.ri bsmn It Raid-r�ain Irlsp Pnsr.red By : �'- r._ ..._......... Mer_hariical Irlscp Witter L. i.ne Call far irISPPC'tian 639--4175 jam' WLWWFIff C17Y F �� SEWER CONNECTIONTIGA RD PIERM I TI6ARD CITY0FTVIERM:I:T 0. . . . » . . a !SWR90-015 COMMUNITY DEVELOPMENT DEPAITMENT ommooK C'RTM» F'E:RMIT 11» : I1f31*90-01.313 13125 SW Hall Blvd. P.O.Aoc 23357,Tigard,Oregon 97�{1K3} ,8?�41)76 DATE: xSSL1Eno 05/01/90 SITE ADI)RE:SS. » » 1.3;32 7 SW £iCf11"rf:i DR 1:DG E Phi PARCEL: 2S104AD 0.3:.300 St.)RDIVISION. . . . : MORNING HIL.L. NCI. ;:3 :7.ON:r.NG: R--4. 5 141..00:K. . . . . . . . . » : T'E:'NANT NAME. . 1.16A NO. . . . . . » . , .. a FIXTURE UNITS. C L.ASS OF' WORK,. .. .. -.111E'W DWI_LI...II46 UN 1:1.5. .. : 1. T'YF'F: OF LISE:. . . . . ..SF:' NO. OF BUILDINGS-. 1 1:1�15TA1...1... TYf'-'E:., » .. . a HUSWR xl'll'I.:RV SURFACE... : I eniarks: !I w r1 a r,., FEES WI::.DGE WOOD HOMES type an+caunt by date -re F.)t. :1:3i?2.501 SW FALCON RISE: DRIVE: F'RMT $ 3.250. 00 I NSF' 9 35. 00 'T 1:1GARD OR 9'7223 F'AYM $ 1285.00 F'L.I... 05/01./90 F-''tiaiie N: 5032923563 C:nnt-ract o-r: _.._____........__..__-___.._............._..... .._—_____.._....._.._..... C;CIN'T'RAI;TOR NOT ON FILE: I't1cr1F� 4y: $ 1285. 00 TOTAL -- - -- RE QUIRE 1) INSI'-'EC'TIONS This Applicant agrees to comply with all the rules and regul,tions Sewer :Irfspe!cticxri of the Unified Sewage Agency., The permit expires 128 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 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 "lap and Side Sewer" Permit and the Agency will inst#4 lateral. _._...____.__..._._.__..._..__._...__._... _._w_.__. 'r.•.-r m i.t t e ra S i.II r1 a t 1.t r c: C:a:1:1 firr'r .irlsp�.:ti.c;r1 639-,,-417"-; C I'T Y OP- T I GARD OF PAYMENT F I-.-.C C.'I P T r 11.) 90-200497 CHECK AMOUPIT a 2 9,-.,C.). 47 NAME s WEDGWOOD HOMES, TNC. CW.'M ANCILIN'T a 0. 00 ADDRESS 4 1,!;'e5O SW F'ALUON FTSE' URTVE POYMENT LPATL O'51C:11 i 90 S UB Ul V I STUN T TGARD. OR' 9 MOF N111.16 HILL., LETT 6 PP 0 S['--' OF PAr tlE*:'t4'T AMOUN T F'-'A 1.1) F-UPPOSE: OF F-`FYYMEN r AMOUNT FAID ........... Oil PLUMPING FF4PM 11-7 .50 MEC'.:H(MICAL. FIE 7.0.Or) HUILD PER 2'4. F P2 CHEU.'. FT." '-'!0. 4",) R USA 1250.00 J:-'WE:F-: INSPECT g40 Ar'0.1 ;.5.00 Ll"FREET SDC 6-00. 00 PA F K S SDC 2 5C 0 0 STORM DRAIN SOC 2!-")0 (313 I'' 'T(0- AMOUNT FAIL) --- --. NA am 13796 SW HoM 91v�d. PIAN CI I TY, APPLICATIOcN CRYOFTIGARD P.O.Box 23397 PLAN CIiF)r-K 1 'ILLI -� �lTIOZ Oregon 97223 COMMUNITY DEVELOPMENT DEPARTMENT (503)639-4177 PFr F DATE. ISSUID JOBADDREss: / :`.'S - CU �•cy /S�j�1��.V ti . � 'U LAX MAP/LOT SUB: P,(.• M [ c Lor: � LAND USE VAIJIMON: _ G�9./G S , - SPECIAI, NUIES NAME: _L G LUQ^ChJ fd c ykC�. Sl^ C_ REISSUE OF: _ ADDRESS: if C, LAS'r REISSUE: FLOOD PLAIN/ SENSITIVE IWO: PHONE:CONMA ?UNQVAi_S_RBZ RE D MR PLANNING: NAME: W t✓-D Gtoc�Crlp + r=A- c._ _ ENGINEMI11G: —_ ADDRESS: yG S ,tU i t,71 FUM DEPT -" PHONE: - t s LEMSF2FJ0[7TIZID BUILDERS BQAR) 1: Sb EXP DATE: U TSST/ BUS TAX: ARCHIENGINEER CAL RATIONS: ----- NAME: r 1 r- C_;- TRUSS DEDULS: _ ADDRESS: (MIER: PHONE: -- 03WE N S: SUBOOMIRACICR:: PILM:,4, !,� -LGL'<i t'� _ 6 1s, - MI)CH: / PERMIT ACrT lC DESCRIPTION AM W- AMDUNT PD. BAL. DUE 10-432 00 Building Permit reds , u 6, 3, rr r 10-431 00 Plumbing Permit Fees // J,SG // 7 u 10-431 01 Mechanical Permit Fees ✓ 3y,ao j� �,, 10-230 01 State Building T`ax (5%) /__- a.�l.s _ a` •, Building P1umb.irx4 __ l / MuCh 10-433 00 Plans Check Fee Building 1 . /,S" Plumbing Jc+ Mech — 7• . ✓ ✓ _ 30-202 00 Sewer Cznnecticn 30-444 0(i Sewer Inspection -�� 51-448 00 Street System Dev Charge (SDC) 600 Ga G 52--449 00 Parks System Dov Ch urge (PJC) 31-450 00 Storm Drairylge Sy-_t Dev Chrg (,,,,SDC) 10-230 06 Fire TETA 0.14 RBC TUU ' (. ��9? • U� APPLICANT SIC MT .r, Ibweived By: _.� _,.--.--...--- --_�- Date Received: L, of/3587P.WPF �■► � ER � IIIA i !� >� � t SAZATIING/E Q,Sl0N CON IMI, INF l� ZMA I m GI NERAL CONTRACTOR NAME&ADDRESS: CAST FIL[ NO.:--- A wes 3 GU 1i A I`b —_F',a.=7khLs�C��–45- =�ur�' APPLICANT NAME AND ADDRESS: EXCAVATION CONI'R.ACTOR ' -- NAMF & Avi)RESS: OWNER NAME AND ADDRILSS: •lliI.EPHONF NUMBERS: —_.—.---- --- APPLICANT: �/ _ � C6, _ PROPERTY DESCRIPTION: OWNER- S'r<.�� STREET ADDRESS AND CROSS STREET/LOCATT-D GENERAL CONTRACTOR: vav•-,O —EXCAVATION CONTRACTOR: ---- SITZ/JOB:__ — — LEGAI.DESCRIPTION: 24 11R/AF-TER HOURS EMERGENCY TAX LOT NO.: CONTACT PERSON,TITLE,TELEPHONE: 114 SEC-F*ION_ -- �0fA.) ;3 �i1 _`�u� sem_ SITE_SIIF --- __ — -- DISTURIIEDA\ORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS SITE RUNOFF DRAINS TO:(CIRCLE ONE)LEAVING SITE WILL BETAKEN (NOTE:I'FRMfiSMAYBEREQUIRED) CATCH BASIN DI`iCH PTFE CREEK en —�-�� -`--- -- (CIRCLE ONE) PRIVATE PROPF.F'IY -- - PUBLIC RIGHT OF WAY R T rd/ST:UIMENTATI 3N MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION: FOLLOWING CONSTRU('T'.ON: SEDIMENTATION FACILITIES STABILIZE.EXPOSF9 SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE Al ID RESTORE TEMPORARY ESC PEPJMETER RUNOFF CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSI IRE OPER ATTON OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OTTIER ---- °LAN FOR EROSION CONTROL PREPARED AND SUr MTI TED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE„INCLUDING MERGENCY PHONE NUMBER, SCHEDULE/STAGiNG FOR I'JSTALLATTON AND REMOVALOF EROSION CONTI'.OL MEASURES,AND API-LIC.ABLE STANDARD NOTES. I HAVE READ AND W[LI.,COMPLY WTI H TTEE ABS?VE AND WIU COf'1STRUCT AND MAINTAIN ESC MEASURES i-4ECESSARY TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE. OWNER SIGNATURE APPLICANT SIGNATURE OIT•ICIAL USF.ONLY. R i 11 I PT DATE ACCEPTED ItiE NUMBER RECEIVED BY v — —