ZCA2018-00005 EXPIRED
ZCA2O18 -
00005
TIGARD
WATER
DISTRICT
RECEIVED
City of Tigard JUL X 9 2018
: . "lCOMMUNITY DEVELOPMENT DEPARTMENT CITY OF TIGARD
TICAR ',
Master Land Use Application PLANNING/ENGINEERING
LAND USE APPLICATION TYPE
❑ Adjustment/Variance(II) ❑ Planned Development(III)
❑ Comprehensive Plan Amendment(Legislative) ❑ Sensitive Lands Review (II or III)
❑ Conditional Use (III) ❑ Site Development Review(II)
❑ Development Code Amendment(Legislative) ❑ Subdivision (II)
❑ Discretionary Urban Forestry Plan Review(III) ❑ Transportation Mitigation (II)
❑ Downtown Design Review(II,III) ❑ Urban Forestry Plan Modification (I)
❑ Historic Overlay (II or III) ❑ Zone Change (III or Legislative)
❑ Home Occupation(II) R Zone Change Annexation (III or Legislative)
❑ Land Partition(II)
NOTE:For required submittal elements,please refer to your pre-application conference notes.
PROPOSAL SUMMARY (Brief description)
Proposal to annex three properties owned by the Tigard Water District into the City of Tigard. Properties total 1.03
acres in size.
PROPERTY INFORMATION (where proposed activity will occur)
Location (address if available): 14200 and 14255 SW High Tor Drive
Tax maps and tax lot #s: 2S109BB01800, 2S109BB02900, and 2S109BB02902
Total site size: 1.03 acres Zoning classification: Washington County R-6 and INST;City of Tigard R-7
FOR STAFF USE ONLY
APPLICANT INFORMATIONCase No.: ZCA2018-00005
Name: Intergovernmental Water Board
8777 SW Burnham St. Related Case No.(s): N/A
Mailing address: N/A
City/state: Tigard, OR zip: 97223 Application Fee:
(503) 718-2609 Application accepted:
Phone number:
Primary contact name:
John Goodrich By:LS Date: 7/18/18
Phone number: (503) 718-2609 Application determined complete:
Email:johng@tigard-or.gov By: Date:
I:\Community Development\Land Use Applications\02_Forms and
Templates\Land Use Applications Rev.12/14/2017
City of Tigard • 13125 SW IIall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 2
PROPERTY OWNER/DEED HOLDER INFORMATION (Attach list if more than one)
Name: Tigard Water District/Intergovernmental Water Board
Mailing address: 8777 SW Burnham St.
City/state: Tigard, OR zip: 97223
Phone: (503)718-2609 Email: johng@tigard-or.gov
`When the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in
possession with written authorization from the owner or an agent of the owner.The owners must sign this application
in the space provided on the back of this form or submit a written authorization with this application.
THE APPLICANT(S) SHALL CERTIFY THAT:
• If the application is granted,the applicant shall exercise the rights granted in accordance with the terms and subject to all
the conditions and limitations of the approval.
• All the above statements and the statements in the plot plan,attachments,and exhibits transmitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,map be revoked if it is found that any such
statements are false.
• The applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or denying the application(s).
f ..,, - rt-e' (r za sz t` 1-1 i 2/i
pplicant's s • r e Print name Date
Applicant/Agent/Representative's signature Print name Date
Applicant/Agent/Representative's signature Print name Date
SIGMA _ ' ES• each owner of the subject property required
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• er s si:,a NJ e Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
MASTER LAND USE APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 2