Report (63) Clean Water Services-Service Provider Letter i
NOV 2 0 2018
are ur TIGARD
BUILDING DIVISION
Submission Date: 11/14/2018 Confirmation#: 60
Applicant Name: Stephen Hansen Review Type: Partner City Plan Review
Contact Email: roy@bluemountainpools.com Ground Disturbance: 624 Sq. Ft.
Contact Phone: " 503-760-4554 New Impervious Area: 624 Sq. Ft.
Primary Address: 14173 SW 155TH TER Mod.Impervious Area: 0 Sq.Ft.
Primary Jurisdiction: Tigard Development Activity: Single-Family Dwelling Grading and
Affected Tax Lots: 2S108AB05300 Retaining Walls
INSTRUCTIONS:This pre-screening report is the Service Provider Letter(SPL)as required by Resolution and Order 17-05,Section
3.02.1. PROVIDE A COPY OF THIS SPL TO THE JURISDICTION RESPONSIBLE FOR LAND USE REVIEW AND PERMIT ISSUANCE.This pre-
screening review does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently
discovered and this review does NOT eliminate the need to obtain additional CWS permits or reviews if project changes in scope or
location.All required permits and approvals must be obtained and completed under applicable local,State and federal law.
erwt It ,P E ia41060 ('{
Environmental Site Assessment No
Review
Water Quality Treatment Review and TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
Stormwater Inspection review and permit issuance.
Erosion Control Inspection Permit TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
review and permit issuance.
Erosion Control Inspection Permit TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
with Site Plan review and permit issuance.
Line Tap Inspection Permit TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
review and permit issuance.
Disconnection Permit TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
review and permit issuance.
Connection Permit TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
review and permit issuance.
Connection Permit with Plumbing TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
Plan review and permit issuance.
Easement Review TBD Not reviewed by CWS.Contact city(primary jurisdiction)responsible for land use
review and permit issuance.
The CWS Development Services group is here to review your project in the most effective and efficient way,while protecting the Tualatin River Watershed.Our
partners include municipalities,environmental organizations,and developers large and small.
Contact Us*2550 SW Hillsboro Highway*Hillsboro,Oregon 97123
phone:503-681-5100*email:splreview@cleanwaterservices.org*website:www.cleanwaterservices.org/permits-development
Clean Water Services-Service Provider Letter
The CWS Development Services group is here to review your project in the most effective and efficient way,while protecting the Tualatin River Watershed.Our
partners include municipalities,environmental organizations,and developers large and small.
Contact Us*2550 SW Hillsboro Highway*Hillsboro,Oregon 97123
phone:503-681-5100*email:splreview@cleanwaterservices.org*website:www.cleanwaterservices.org/permits-development