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9730 SW CASCADE AVENUE STE 212 ADDRESS: C95=de ,due out" u , � !� is\records\microflm\targets\building.doc CITY OF TIGA. RCS 7•I F I GA7'fr; OF COMMUNITY DEVELOPMENT DEPARTMENT OC.I:.. . . . ti ISM SW Wink Blvd.TWW,Cs� ennellOP (5"$04171 F'EiZM i T li. . . . . . , s BUP95•-4.t�t49 DATE ISSUED. la/19/TS GARCEC.t 1 S I Z'7DD-•00100+ SITE ADt?Rew�iS. . . ¢ 09730i �"aW CASCADE AVE 1�:� SUBDIVISION. . . . i 7..ON I NG s C-G BLOC'K. . . . . . . . . . t LOT. . . . . . . . . . . . . a CLASS OF WORK. s AL7 TYPE OF USE. . . s CUM OCCUPANCY GRP. s 3N OCC:UPnNCY LOAD s 0 I rLNANT NAM2. . . i nR HAWK I P45 Pemarksr MOVO walls and instill doors T. MICHAEL & ASSOC. _ ' 200! F MINERAL PVL ENGLEWOOD CO 8011► Phone #- 303-792-:33il 24 MILLENNIUM BUILDING SERVICES 141.4 N M14SON PORTLAND OR 972.17 Phone #s 281--1949 Rey #. . : 036351) Oct:u.pancy of the above referenced building is hereby give,,-i, And certifies the compliance with the ;state Jf 3Pecialty �-odRs for the gr^oi..tp, ocrUpaniaW-1 ..iAnd Uscr Under which the ref'prencecl p, mit ways issued. E�UILLIINO Nc3F�icC1C1R HUII.•.DI,NG OF CI-L POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone):6QQ39-4175 Business Phone: 639-4171 Inspection:_ =ooting Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line �c g. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: / — Time: AM PM Address: te —7 l_ ( I ?j C-�j �, Q �' Qom-�� • ��(/ Builds �Y)i GZt� — Permit THE PLOWING CORRECTIONS ARE REQUIRED: J �- • .�,..-�1.��.s,�.c�,�-sem � i►�c.. �,r�[ ct 77�,, Inspector:_ _ Date: APPROVED DISAPPROVED /-- APPROVED SUBJECT TO ABOVE _Call For R,3insp. 1 1 1 1 1 1 I 1 j��� � r-J �i•r 11�:.' �w�7��'���1;L� t o y���� �� 7�� � j�jl*J�(;1�.RJ������`I''-.�kC,tw�1^.•►ih'Y�����L� - �•I {� ��ri► 'Y �i 1C�`,�'��,��1i�, w '• r var\�r;••1i�1:3<�'ac.�\��.Lj7`=:i1G��l�►�•n},;q�?��t i:1� ':t N �. � � N r `�,�� ��.;�'1��?� U ! �f '";i1,��`t�jt�` tit%'f�tl• r b>' . 1+:=i '►:� ;�lZt-,"��'�rr�.gIi(l7t'•;.y,�;,i Rk, ,�uy�tC�,=^�\�`S�r�1���!�' � ,f t] CJ ":,�'Ca�i►r�t'l' r:►' t�, YA -1A?41. •t`' 7,{ j "*.�.�111V .1�.I.�3 � ��3 �1 �1~►fib �eri�ry.� F< 7` i llV��Z'[•�ZS'�r_;r.�.�'.iS'J J ✓,t�,'�}\-s- Ltim �,• �! r. a► '?�.�i �. [ �� • �' � ark tilt c'f)):.'�hN_ �1I��'�� ry�I�it� �•�'� 1�y� c' • kfdw �(T fir,a:'•L'.ly; =�,•��7�31 • tS i! r4 .t. �7 r. �ci �~-'• {�"t, .,a :,�• by .}' • jP. I • L�7A , .1 r' � � �' 1 , t : : .: • min yI• •h i I V 1 t: , WIN wrm k• � lit ® 1 ,�[ 0 Ill ■orm 'r �, CITY OF TIGARD BUILDING INSPECTION NOTICE 4 Inspection Line (Rec-O-Phone),;•6S1a�1 `5 Business Phone: 639-4171 1;Inspection: CLr.,( rv] ,� >r it w D .rl� in r - � "� Y � � iwl Footing Susp. Coiling S rink. Rough-in A NSdwlk " !' `• "� �� Foundation Plb Underslab Mech. Rough-in Fireplace 9• 9 P r 3s yr 1�i ; ' L14 edo ,' I' Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL: ,~' !!� ". �"! ,� iL ' Post/Beam Mech. Sari. Sewer Gas Line Plbg. Undortloor Rain Drain Framing -Plumb. Alam Water Line Insulation -Mach. "`r v atl r ��4 I ,• � i �fy �r Underflr. Insul. Shear Wall Gyp. Bd. Elect. Date Requested: ��- ��;ti Time: AM PM 1' C Address: �.� �_f�-�' _ '•'y;' w1 )C rC/,f.l�"1Q" Build — Permit !12� THE FOLLOWING CORRECTIONS ARE REQUIRED: • z i" 11�1 ACO � • a 77_H •. �c�v r• s.. �b .1.1 - �1 r� i, N) Inspector: _ D tel/t 1 -� 7 Z� 111 ;r APPROVED DISAPPROVED /,'-'APPROVED SUBJECT TO ABOVE _Call For Reinsp. ' r ' •` d ' .F'.r V r' •ill ` '.r `r - 'I� ..�. .. ' C't 5�r '•1 a� r'J�• i ��''!G` 1rriR' �r' �' !r�%. " �'`Fi' 111► 20 'd SZO&K 'ON XVJ OAS ON I M I AG wn I NN311 I W OE:01 03M S6-02-030 C - CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plog. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underfl,. Insul, Shear Wall Gyp. Bd. CAC) Date Requested: �. .� Time: AM PM Address: C� Builder: : 2-Permit #: jC' �-- THE FOLLOWING CORRECTIONS ARE REQUIRED: l f � Inspector:'( L? gy Date: —APPROVED DISAPPROVED _NAPPROVED SUBJECT TO ABOVE — _Call For Reinsp CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: V < Footing Susp. Ceiling Sprink. Hough-in Appr/Sdwlk I Foundation Plbg. Underslab Mach. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Cas Line -Bldg. Plbg. Underfloor Hain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul Shear Wall G> -Elect. Date to Requestod: Time: AM PM Builder: rj Permit N:� �0 THE FOLLOWING CORRECTIONS ARE REQUIRED: I I Inssptor: Date:—/ p _APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE -`Call For Reinsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-0-Phone))://619-4175 Business Phone: 639-4171 Inspection: L Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underelab Mach. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mach. San. Sewer aas Line -Bldg. Plbg. Under,,00r Rain Drain Ffaml -Plumb. Alarm Water Line Insulation -Mach. Underflr, Insul. Shear Well/ Gyp. Bd. -Elect. Date Requested: rl�� I l I `J Time: AM _ PM Address: G Builder-- ��t.n (• (�l �� { _Permit #4-L.c, • - G����r THE FOLLOWING CORRECTIONS ARE REQUIRED: 41/17 Inspect r. .sCLd i Z_ _ _ Date:1?__— �AP"ROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE Call For Reinsp. BUILDING PERMIT CT #. . . . . . :ITY OF TIGARD DATE 1 ISSUED: . 11/30/995-04495 COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Hall Blvd.Tigard,Oregon 97223.6199 (503)630-4171 PARCEL: 1.91.2'71)D-001090 SITE ADDRESS. . . : 013'730 SW CASCADE AVE. #212 SUBDIVISfON. . . . : ZON G:C-G � IN BLOCK. . . . . . . . . . : LOT. . r ____.___----------•--------_____-----•---------- ��.�...�._---------- REISSUE: FLOOR ARF_AS ------- - EXTERIOR WAI_I_ CONSTRUCTION-. CLASS OF WORK. :ALT FIRST. . . . : 0 sf N: S: E: W.. TYPE OF USE. . . :COM SECOND. . . : 0 's f PROTECT TYPE OF CONST. -5N . . . . 0 sf N: S: E: W: OCCUPANCY GRP. :132 TOTAI-------: 0 sf ROOF CONST: FIRE RET?: OCCUPANCY LOAD: 0 BASEMENT. 0 sf AREA SEF'. RATED: STOR. : 0 I-IT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED: SSMT? : ME:ZZ?: REUD SETBACK.3-------- REQUIRED-- FLOOR LOAD. . . . : 0 ps•F LEFT: 0 ft RGIAT; 0 ft FIR SPKI-.: 5110K DET. . DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BF_'DRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 5000 Rema_t-l(s : Move walls and install door^s. Owner: I­. MICHAEL. & ASSOC. type amount by date r•ecpt 9200 E MINERAL AVE PLCK $ 32. 83 JSD 10/27/95 95--272197 FIRE $ 20. 20 JSD 10/27/95 95-•272197 ENGL_EWOOD CO 80112 PRMT t 50. 50 JSD 11/30/95 95-273384 Phone #: 303-79,2-3500 3500 15P PCT $ . 53 JSD 11/30/95 95-273384 Contractor: -- ____.---.____---•--_________-__-- MILL.ENNIUM BUILDING SERVICES 1414 N MASON PORTLAND OR 97217 --...------------------_----._-----------.-- phone #: 281 -1 )49 $ 106. 06 TOTAL Re❑ 4. . - 036359 ------- REOUIRED INSPECTIONS This permit is issued subject to the 7:,­lations contained in the Framing Insp Tigard Municipal Code, State of Ore. Specialty Caps and all other I n s U 1 at i on Insp applicable laws. All Mork will be done ire accordance will-. F i rewa 1 1 Insp approved pans. This permit will expire if work is not started Gyp Board Insp within 190 days of issuance, or if work is suspended for more Susp Cei lnq Insp than 180 days. Mi.s^. Inspect ion Final Inspection F'c�rmitEee `. �. P3 �.ir� , _. __._ _._____ __ �..__..-._..__._._._ Iss�_ied Bv : _.__...._..........._ Call for inspection - 639•-4175 C I T Y OF T I GARD - WL:F I V T OF Pi aYME'A T Wk-Gk X k( NO. d 41i--c?l:S:st14 f.HL-.I":K W41UUNT o `l.i. (a S N11MF a M I I_L..kNN 1 UM BUILDING GASH 1.1MOUN r 1 0. Olb ADDRESS a SERVICIES PP.'IMk-NI DAA r II/;0 1.45 1*41t N MASON ST SUBDIVISION s PORM-ANI1 OR 4 7P 17—;3P 3N PURPOSE OF PAYMENT 0111.11.JN T PAID PURPOSE OF PAYMENT flM1.lt.)N! PfA l b 141.11 I..0 T N13 PERM MUP45--0444 050. "51A 81. 111_I 1 tJ) PER k'. 5.3 4730 8W 1,0173GADF 14V1; 1111 Fat_. .J3. 03 w w� r li ii � nlarn U� ID o=oC �v\ FAArnO. IDV �j ail v a ' L'L C _ _ 3 � o A III �i > V o aC o r4 CQ ) o b r C� i -CC C) a��Uo � 03C ;cpm c� zoE. a, e-zcarna. 't•1 �` Tru 1 .i G C � w 0 M \\ 7) 1 0O 0OI .Z -- C�co 3 C, tk r. U O (® M rr- _ �, - CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171 Inspection: � �, lglj t,,, At-/N Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-inINAL. Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp, BdElect. Date Requasted: Z Time: AM PM Address: Builder: Permit #: /S'- "'G rj �, Z. THE FOLLOWING CORRECTIONS ARE REQUIRED: - / —S_'_LZC7-7 -T f Inspector. Date: ,APPROVED —DISAPPROVED AAPPROVED SUBJECT TO ABOVE Call For Reinsp. CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC95-0562 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 11/15/95 13128 SW H&N ellvd.Tlgud,Onoon 97223W99 (503)639-4171 PARCEL: 1 S 12 7 DD 00100 ITE ADDRESS. . . : 1419730 SW CASCADE AVE #212 SURDIVIGION. . . . : ZONING:C-G L?L-OCV. . . . . . . . . . . LOT. . . . . . . . . . . . . . Project Description : First branch circuit -----RESIDENTIAL UNIT---- ----TL-"MP SRVC/FEEDERS---••- - ----MYSCELI_ANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0 ErICH ADD' L 500SF. •, . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0 IhANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LAPEL {10> . . , 0 - SF_RVICE/FEEDER-•---- ----BRANCH CIRCUI'1'5---- - ---ADD' L INSPECTIONS—— 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 •- 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . .. 0 401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ____________..___.._.F'L.AIV REVIEW SECTION-- _.____.___.___._-__._. 1000+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Rer_onnect only. . . . . : 0 SVC/FDR ) = 225 AMPS— : CLASS AREA/SPEC OCC. : Owner: --__.__----_- ----___________.__..____.___.____.___._..__.________ FEES DR. HAWKINS type amount by date recpt 9730 SW CASCADE BLVD #212 PRMT $ 40. 00 P 11/15/95 95-2721936 5PCT f 2. 00 B 11/15/95 95-272936 T I GARD OR 97223 Phone #: Conti•actor, 4.x. 00 TOTAL dR%HREFN F- Ice-, CM, ,1Ms . (07-60 SUJ Id wlakS five ------- REOU I RED INSPECTIONS ------ - `1`1zz3 Ceilifrg Cover Elect' 1 Service (hone #: (F -7`1`52-- Wall Covet° Ulnct' 1 Final Rey #. . : This perait is issued subject to the regulations contained in the Pa Code, State of Ore. S ►-, _ �{/ Tioard Munici 1 Specialty Codes and all other e>~b itt ee Si g _ P applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more , than 180 days. Issued By _ W INSTALLATION The installation is being made on property I own which is not intended for sale, lease, or rent. (IWNER' S SIGNATURE: DATE: - -------- - -------------CONTRACTOR INSTALLATION SIGNATURE OF SUPR. ELEC' N: DATE: I__T CENSE NO: Call for inspection -- 639- 417`, Community Develonrnent ELECTRIC,pL PERMIT APPLICATION 13125 SW Hall Blvd. t L Tigard, OR 97223 Permit # ���' 'r 5(0 Z- Date Issued If - Phone I -Phone (503) 639-4171 CITY OF TIC3AI�D FAX (503) 684-7297 TDD No, (503) 684-2772 Inspection (503) 639-4175 1. Job Addrp r:a: 4. Complete Fee Schedule Below: Name of Development 5//-4 �I k c c , azQ Number of Inspectionspar permit allowed Address-49-736_ _S/-0 C ,3�-A --Qq -4Yl= Service included: Items Cost(es) Sum City/StatE/Zip S�r� ����_�j �?..�Q� 4a. (Residential -per unit '� 1000 sq, ft or less $110.00 Name (or name of business) _ ff tai /L-�j I Each additional 500 sq ft or portion thcreof $28.00 Commercial Residertial ❑ Limited Energy -- 025.00 1 Each Manut'd Home or Modular Dwelling Service or Feeder $88.00 2 2a. Contractor installation only: r� 4b.Services or Feeders Electrical Contraetor(lyp 1i4 1C[�EE� Install-lionrmp alteration,or rolacallon 200 amps or less $60,00 2 Addres51 C, li0t 145}S 1>! 201 amps to 600 amps 11180,00 2 � 401 amps to 800 amps 3120.00 2 Sr21El rt Zip e7_ 801 amps to low amps __ $180.00 2 Phone Q �'l rs�� �_ YUra� Over 1000 smns or VOM$ $340.00 2 Job NO. Reconnect only _ 5550.00 2 contractor's license No.�.s 4c. Temporary Services or FaeCers I Contractor's Board Reg. No. r _ Installation,alteration•or relocation Signature of Su . Elec' - 200 amps or I-ss !_ 2 r License No. S Phone Nol[ -rS2 _ 201 amps to 400 amps 550.00 2 401 amps to 800 amps $7900 Over 800 amps to 1000 volts 5100.110 2b. For owner installations: see'V above 4d. Branch Circuits Print Owner's Name New,alteration or extetlslrm per pane Address a)The fee for branch cirrults with Purchase of service or feeder fee. 2 City _ State, ZIP__ Each branch circuit $5.00 Phone N0. _ b)The fee for branch circuits without The installation Is being made on property I own which is purchase of service or feeder fee. ere,) 2 Fist branch circuit not intended for sale, mase or rent. _L $35,00 Each additional branch circuit 1 $_ 55.00 Owner's Signature _._. __- 4o. Miscellaneous (Service or feeder not included) 2 3. Plan Review se,-tion (if required): Each pump or Irrigation circle $40.00 2 Each Sign or oultine lighting $40.00 Signal rlrcult(s)or a limited energy 2 Please check appropriate Item and enter fee In section 68. panel,alteration or extension $4000 r_ 4 or more residential units in one structure Minor I-Abell(10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional Inspection over Classified area or stnrcture containing special occupancy the allowable In any of the above as described in N E C Chapter 5 Per Inspection $35.00 Per hour $5500 In Plant $5500 Submit 2 sets of pians with application where ,y of the above apply. Not required for temporary constructlov :ervices. $. Fees: 6a. Enter total of above fees $ tn'r�' NOTICE 5%Surcharge (.05 X total fees) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTIONSubtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 'DAYS, OR IF 6b.Fnter 21511, of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Re dew if reouired (Sec,3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS sublltot'rl $ COMMENCED r, .^�•��• I-1 Trust Account # n^•an Balance Due $ CITY [IF, 1,jC3j4MDPAYMI-.*Nl RF(',FIP'T NO. PIP cWcK MMIJUNT r 4i4. 00 C149H AMLJIJN 1 0. 95Q) NAMS CREFURFEN L:.1-ECIRICAL v'PVMV-NT DWE I 1 15 95 joebe SW NIMAUS AVk M- HUBDIVISIVIN PORTLOND OR 97P—P3--. pLjVp()qF'. cif:- PAYMENT (4MOLIN T PA 11) PURPOSE op PAYW-Nr AMUUNI PAID E. 40. 00 87'. BUILD PFR 1,1 (.,TRlrAl- PFRMI*l 4 OW CASCADE #21P ELG 95-056e l (iiiji- AMIAM PAIL) i • Com ercia TSul (Permit Application City of Tigard " f T2 Y3125 SW Halld. i� - 1 igard, OR 97123 c i 9 f503) 839-41 C'¢, �% I Jobelte Address: 4,0F& Ac/� �/ Office Use Only Tenant: yam � Az 'W—j- suite# �./�Z _ AF! Planck/Reu Valuation: Permit -�-� Owner: /" , ^ s-_ xe Map & TL# Address: 91, _ � /�li.�r.A�+l a►°v� ApprovalR eguired ��arl ✓ 001_ C a. 2o4//� Planning Phone: X9 a- SOC Engineering ) ' Other l / C� 771 Contractor: (� Address: �//�/ A/ .�l.�S�Y✓ 1'l- Type of const: Occupancy class: Phone: 1w) � o-3 r Sprinklered? Yes Contractor's License #_ r (attach copy of current G n icense) Sq. ft. of project: 114b Contact name & phone: f Story (1 st,4 gnetc.) Propose, se: _,!�100111te- � Architect/Enginser: Previous use: ehl i CC Address: r Note: Plumbing & mechanical plans must be submitted at time of building permit application. Phone: JOB DESCRIPTION: jloye Applicant Signature & Phone number Received by: Date Received: Permit* Account Description Amount Amt Pd. Bal;Dia , Bldg. Permit (BUILD) Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: Mach: Plan Check (PLANCK) L,` ✓ J � Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parke Dev Charge (PKSDC) Residential TIF MF-R) Masa Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-I) Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) �,�0 C c'�? Erosion Critri Permit (ERPRMT) _ Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) TOTALS: lid ,_.� i C..l I Y OF 1 1014 RD - Rt.Ck 1 f-''1 Uf- PO4YMl::.N"I IRFAA I FI T NI'1. CHEEK AMIJIIII 1 x. 00 hJf�l a Mt1._LF.14NIUM 13LDG E:iRRV CMWA NMOIINf S3. 03 Hl)UftEss, r 14] 4 N MASON HT PAYNII-N1 DviII: Pi..)RI LAND UR 4U1301 V Ji I C►N ri 7: 1.7.- PI)PPOSV tIf PAYW N F 4MlAIN1 1-11.111) PURPOSE C)F P14Y!,1 +1l MNCIONI Pt-111) llilll.l!INt, PI-ON CHKCK 3p. 814 1 IM I 111- W-WP-Y PI NN CK 0. trt } .130 8w tlof`A.4,11)F AVE 1,1 4N CVIV.UK #]PI_.'7GIC' i 1111441_ AMOIIN1 PAID _ _. ._ _..) 15 . 12111