Report MS7-2020 - o0 4/3
CleanWater Services Service Provider Letter
Our commitment is clear.
Submission Date: Jan 24,2020 Confirmation#: 348
Applicant Name: WARD,JEFFREY CWS File#: 20-000238
Contact Email: jeff.ward32@comcast.net Review Type: Partner City Plan Review
Contact Phone: Ground Disturbance: 56 , }
Primary Address: 12080 SW 116th AVE New Impervious Area: 0
Tigard,OR 97223FEB 6 202,i
Primary Jurisdiction: Tigard Mod.Impervious Area: 0 =� ,
f ;
Affected Tax Lots: 2S103BA00124 Development Activity: SFR Addipt�n"•g �z k� t'y
Project Description: 56 SQ Ft addition;;Sfd Addition
FOR DISTRICT USE ONLY
❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or
within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and
protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider
letter as required by Resolution and Order 19-5, Section 3.02.1,as amended by Resolution and Order 19-22. All required
permits and approvals must be obtained and completed under applicable local,State,and federal law.
® Based on review of the submitted materials and best available information the above referenced project will not
significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre-Screening Site
Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are
subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-5,
Section 3.02.1, as amended by Resolution and Order 19-22. All required permits and approvals must be obtained and
completed under applicable local,state and federal law.
This Service Provider Letter is not valid unless 1 CWS approved site plan(s)are attached.
❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2).
NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
❑ NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed By:LDRToolReview Date:January 24,2020
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