8210 SW PATTI LANE-1 001 I
N
CJ
U.
LJ
a
rt
rt
N•
r
i
r
1
b210 SW Patti Ln -
WINN
CITYOFTIFARD
L"C"FZT I F l CATS Or
Cly X TWARD OCCUPANCY
COMMUNrrY DEVELOPMENT DEPARTMENT' ORec>Ow PERMIT M. . . . . . . : M ST9k1 "096
11126 SW FWI Blvd. P.O.%=23397,TOW,orpon 97229 JW)OPQ-4176
_ T.a..,Mr.
71757 13 111
I'TE 14i)L)R(Ita�J. . . : 1:ir. .i 0 5W I;)ATT I LN PARCE E_: 2a 1 12CC- klt'9'aD
.-jUBUIV181 ON. . . . I L.C1NOTRE.E= ESTATES ZONING% R- 12
. . . . . . . . . LOT. . . . . . . . . . . . . 31.
OF WORT:. :NEW
T , ,--r_ OF UE-31i.. . . e SF'
OCCUPANCY C)RP. :R3
OCC FANCY l OAD t 220 4
TENANT NAME—
Remark s a
Owner.: _.. _.__._____.__.. ..._._. --_.._..._.._......._.
TITAN pROPE:.RTIE S I
P10 BOX 6635
ALOHA .(,IN 9 7i ft'7
Fhune #t 6455477
Cant re:r.A or-.t
TITAN PROPEW.T IES
FSO BOX 6835
i41.0140 r R 97007
Phunp iF: 6456477
Occupancy of the above referenctud building is hereby yi.ven, and r r�r t :kl rcr;
the compliance with the ";targe Of Oregon Specialty Codes for~ the grolAp,
occupancy, ,an.l Use under which the referenced permit Wda4
FIRE DEPARTMENT ' U I L.D INE3 INSPECTOR
I I...
DING
POST IN CONSPICUOUS O1_ACE:.
INS EGTIOF NOTICE � � j
City of Tigard Building Depati:ment
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)= 639 4:75 2ueinean Phooe: 639-4171
Fooring Flby. Underslah Hoch. Rough--in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing Q
Poat,Oeam Mach. Rain Drain Ir.sulatlon P1
Plbg. Underfloor Nater Line Gyp. Bd. / Neeh.
Date Requested: Timet
Address: /—���G� Permit #t�
Rui]der �_ _ •�^
TF1F.. FOLLP-WING MRR=CTIONS ARE RIWIREDs ...._.._._,... ._..,
MOZ
Inspectort_,—___ _—_ Date13-13
n�
_i�APPROVEO —T U=QAYFROV.ID AP''ROVED SUBJECT 'n1 ABOYR
Call For Reinsp.
INSPFCTION NOTICE :
City of Tigard Building DOPa "t -
13125 SM Ball Blvd. Tigard, OregOn
Inspection Line (R@c-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _� --------- - --�
Footing Plbg. Undersleb Mesh. Rough-in
Appr/Sdwlk
Pound. Plby. Top Out
Cas Line FINAL:
Framing -Bldg.
post/Begun Struct. San. Sewer
Post/Beflin Nech. Rain Drain
insulation 'Plumb'
Oyp. Bd. -Koch.
plby. Underfloor Water Line /
`? I1 -e ._T�� — AN �PM
Date RPqueeteds
Permit
Addrees:
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
--------- _
Date:-
Inspector:
11PPROVED ,_ DISAPPROVED J� _ APPROVFD SUBJECT TO ABOVE
Call For Reinap.
INSPBCr�,ION NOTICE '
City of Tigard Building Depart—nt
13125 BCI 861.1 Blvd. Tigard, Oregon 97223
Inspection Line (9ec-O-Phone) t,39-4175 Business Phores 639-4171
)nspections�
Footing Plbg. Uddhrslab Mech. Rouyn-in �jQpr/__Sd�
Pound. Plbg."Top Out Cas Line PINALs
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Mech. Rain Urain Insulation -Plumb.
Plbq. Underfloor Nater L--innee Gyp. Bd. -Hoch.
Date Requesteds_ �~ / / ___Times _AN PN
Address: Permit
G
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIREDs
Arti Gc. ( S 14 12—
Ail
Inspectors � 1 _ Dates
APPRDM1IRD DIRAPPROVRn APPROVED StISJFCT TO ARM
':allFor Reinsp.
INspzcwoN NC�f�CF
City of Tigard Building DepartaWInt. J![/
Hall Blvd. Tigard, Oregon '17223
13125 Rq Ilal 9
Innpection I.ine (Rec.-O-Phone): 634-4175 Bunineas Phone: 6Jy-41.71
Inspection:_____
FootingPlbg. Underelab Rough--in Appr/Sdwlk
Plb Top Out ¢ar..Line� FINAL:
Found. Q'
Post/Bea:u Struct. San. sewer Framing_ g•
Post/Beam Hoch. Rain Drain
In�n -Plumb.
Plbq. Urde.floor Water Lino ayl'• Bd.
-Hoch.
—
Date Requested: / ��r ----Time: - -PH
_ t �
Ad<Izenet Permit
- -
B+:f Idem
THE FOI.I.OWING CORRECTIONS ARE REQUIRED:
nate:
PPROVRD _ DI PPROVED APkROVED sIIBJErT TO ABOVV
�— Call For Relnep.
xMaP� Ioe�r_asCE
City of Tigard Building Depa:tMot l
13125 SW Bell Blvd. Tigam. Oregon 97213
Ine,pection Line (Rec-O-Phonn)e 639-4175 Ruatnepo Phone, , - 171
Inspection•_ _r— --
Footing Plbg. Under lab Mach. Rough-in Appr/adwlk
Found. Plbg. Top Out Gas Line FINAL,
Poet./Beam Stcuct. San. Sewer PraOin9 -11149•
Poet/Beam Mech. Rain Drain naulati� -Plumb.
Plbg. Underfloor Water//Line Gyp. Bd. -••� -loch.
Date Requeste-1, �r �L� Time, _A,_AM PM
Addrenn s __ i Permit 9 S
Builders _-
THF. FOLLOWING CORRECTIONS ARE REQUIRED:
Inapector, 7 / / Date, /
-Z� JAG
yAPPROVED DISAPPROVRD APPROVED 9UBJBCT TO ABOVE
Call For Retr,ep.
�ttl3�c�r1oN NOTtc>
City of Tigard Building Departmm*
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ruc--o-Phone): 639-4175 Business Phonet�639-4171
Inapec:.ion t
Footing Plbg. underslab Mesh. Rough-in Rppr/Sdwlk
Found_ Plbg. Top Out gas Line FINAL:
Poet/Beam Struct. Srn. Bower framing --Bldg.
Poat;•Beam Mech. Rain Drain Insulation -Plumb.
P1 bg. I1nderflnor Nater Line gyp. Ed. -Meeh.
Date Requested:_[ - �� �__Times _ —AM PH
Addresa:— '�12/0 '?-1 - 'ermit
Lula iec•:
THE F01.1k)WING CORRECTIONS-
Inaprctor:_-- - --- Date7V
_ APPRON6D _ DISAPPROVED AI%PROVRD SUWRCP TO ADM
Call For Reinep.
�INfiPF.110q. NOTICE
City of Tigard Ruil.ding Depatttaent:
�i125 80 Hall Blvd. Tigerd, Oreg.3n 97223
.nepection L1.ie (Rec-O-Phone)• 639-4175 Business Phone: 6 h
Inspection:
Footing Plbg. Underslab Mech. Rough-in� Apkr/Sdwlk
Found. Plbg. Top Out Gas Line FfNAL:
Poet/Beam Struct. San. Sewer ( Frami g -Bldg.
Posit./Boam Meeh. Rain Drain Insulaticn --plumb.
Plbq. Undarlloor Water Line Gyh. Bd. -Mach.
Date Requestedt_ /z may _-Time: i�i\M _&_PM
Addross•__ -./� Permit f:
Builder:
THE FOLLOWING ODRRECTIONS ARk REQUIRED:
—K671U!/� ,'.�JCZ�rC�i s �C •�-CIES S�n+.si-lc.
JAL ED
Iidrysctor: Date; 7
APPROVED DISAPPROVED APPROVED SUBJECT TO 1,BQVE
Call For
Ip3PBC'PION N�YTICL �yyy���,
City of Tigard Building DepartAwnt
13125 811 Hall Blwd. Tigard, mogon 97223
Inspection Line (Rec--o-Phone): 639-4175 Business Phone: 639- 71
Inspections_ ----
Footing Plbg. Underelab Hoch. Rough-in Aopr/Sdw).k
Found. Plbg. Top Out Gab Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rnin Drain Insulation -Plumb.
Plbg. Underfloor Nater L�i7ne Gyp. Bd. -Koch.
Date Requested: 1� / 7 0 Times _X _AK
Addresef �O��J /"l�,L-�C� 6n _ Permit #f
Builders� _
THE FOLLOWING (MRRECTIONS ARE Q RED:
,.i L -._ ---- -
ILA-
-_. -- ---
:
Inspectors _,--_—_ Dates_ y /
-PROVED DItAPPROVSD APPROVXn SUB;6(:T TO ADM,
Call For Reinep.
l,�ISP6CTlON Nt7TICR f
City of Tigard Building Department
13125 SCI Ball Blvd. Tigard, Oregon 97223 f
Inspection Line (Rec--o-Phone): 639-4175 Puniness Phones 639--4171
Inspections` _—
rooting Plbg. Undeerrs`laab Hoch. Rough-in Anhr/Sdw A
Found. (-P1bg. oT PP Gut/ Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Cuter Line Gyp. Bd. -Hoch.
Date P;yueated:, Timet >e' AM PH
Addreset� Petmit tC?— �G
Bul lderm
THE FOLLOWING CORRECTI B ARE RxwrRED:
Irspectorm DatesL �C .
APPROVED DISAPPROVED APPROVED SUBJECT TO ASCM
Call For Reinsp.
ss�s�
i
I
INSPELTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection , _ �'-�o�r✓ _
Date Requested-h) Lam-_ Time_ A.M. ' P.M.
Address _ i7�1 _ Permit
Owner— __ Lot #
Builder
The following Building Corie deficiencies are required to be corrected:
Present,sd to proved` `
Inspecto ❑ Disapproved
Data o
CQ LL FOR REINSPECTION
U YES C:1 No
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone:
161394175
_
L
Type of Inspection"*�
4/17
Date Requnsted Time A.M. P.M.
Address Permit *-ZQ—
Owner Lot #
Builder
"he following Building Code deficiencies are required to be corrected:
Presented to �-Approved
1
Inspactor I I Disapproved
Date e9117)
CALL FOR REINSPECTION
❑ YEI NO
i
i
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested_ ,2 :21 - Time A.M. P.M.
Addresszzz_c_ "Gr/
a�-Qermit # d�f
Owner y/
/(� �t
Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
Inspector -y -W�.
-- --- ❑ Disapproved
Date s '
CALL FOR REINSPECTION
❑ YES ❑ NO
I
INSPECTION NOTICE
City of Tigard Builriing Department
P.O Box 25397
Tigard, Oregon 9722.3
'hone: 639-4175
Type of Inspection //it s%t.�.�C(/[a� y- - 1i'I,p
�r
Date Requested
' Time A.M.__ _.P.M.
Address -__��Lz�---- �L�- - --- ---- Permit
Owner Lot #.
Builder ---
The following Building Code deficiencies arc required to be corrected:
Presented to __— --- -- 0 Approved
Inspector -- —J Disapproved
Date
CALL FOR REINSPECTIOiV
W68 0 No ,
r� INSPECTION NOTICE
IL-/ City of Tigard Ruilding Department
P.U. Box 23397
Tigard, Oregon 07223
Phone 639-4175
Type of Inspection
Date Requested 1 407 Time A.M. P.M.
Addresi Permit
Owner _ . _ __ Lot #
Builder __ i�-^yt 1 ---- ---The following Building Code deficiencies are required to he corrected:
Presented to �-Approved
Inspect— Disapproved
71,7
Date. -- ...�
AL REINSPECTION
C] YES 171 NO
ITIOSTER PERMIT ✓
P,E R M IT #. . » . . . . . MS'T 90 (a 0':)L,
CIT''1 OFT IFATWARD PRIM. PERMIT 1111. - MST900096
COMMUNITY DEVELOPMENT DEPARTMENT oRwow 1)A T[7 IF:)S
UED: 09/1.2/90
13126 SW HW!Blvd. P.O.Bcw 2331.77,Tigard,Oregon 97273(EW)639-4176
)H. � . ..9
SU14DIV161ON. . . . I_`11 G T R L E. Z 0 11 N G
DLOCK. . . . . . . . . . : LOT. . . .
BUILL 40
R 1-'-*1:135)U E:5 2 3 /GA DWELLING UNIT,'qi -j BASEMEMI.. . . . . . . . 10 3 Sf
CI.OS,15 OF WORK. :NEW B E D R MS:3 T,", - 1 8-.9 GARACIL. . . . . . . . . . . :530 5 s
TYPE OF USE. . . :SF FLOOR AREAS— REOUIRED
TY!_-'[:_' OF CONST. :5N F.1:RS I .. . ., . .15 0 C) S f LEFT. . ".52 ft RIGHT-0,3 f.1,
()(,C",UPANCY GRP. %R3 S!�COND. . . -98 ssf FRONT. -2Y ft REAR. 89 f(:
TO RT E S.. . . . . . . ..2 T 1,41.R D. . . ..0 16 R E(A U 1:RE D
1-11:_:'IGHT. . . . . . . . ..20 ft TOTAL-- ----. --:48 s SMOKE DETEXTORS. 02
F1.0 0 R L 0 A D 4H lisf VALUE..... $e 75570 I-JORK,114G SPACE'S..
FN'e ni a r tc s n
PLUMBING
. . . . . . .. . .
SINKII: -.2 FLOOR DRAINS. . . . :0 RAI'KF LOW PREVNTRS. .
1_AVATORIES. . . . . t3l WATER HEATS . . . . . . . . . . . . . .
TUB/SHOWERS. . . . ' 11 LAUNDRY TRAYS.. . . .0 CATCH BASINS. . . » . . .
WATER CLOSETS. - a0 SEWER LINE (ft) . -.00 GREASE TROPS. . . . . . .
D15HWASHERS. . . . '. 10 WATLR LINE ( ft) . C-0 0 OTHU'R F',TXTURF-.:S. . . . . ..0
OOREIAGE DISP. » » :0 RAIN DRAIN (ft) . ' 10
WAISHIFIG SF RAIN DPCiINS. . .-
................................__... MELHANICAL F:.F..ES
FUVI... UNIT HTRS. . -,0 t,,pe anlot.kilt by (late r e c,p t
I- * '
VENTS . . . . . :41 PAYM $ 40. 00 JLH 0 $/09/90 107 703
NON INPITT'.'010rl) BTU VENT FANS. . :01. B I.)R T $ ;3E,1. 00
F'ORN ( 1.00K . . -0 HOODS. . . . . . 10 BPLC $ 40. 00
17 URN )=1 OOK . . -.0 WOODS TOVES., I B51lc 41 1.8. 05
1:1 (3OR F:URN. .. . . a U'Ll.) DRYERS. - :1 STDC 1 600 00
110 1'1 /(I'MP < 31AP OTHER UNITS: 1 SSDC $ 250. 00
G 0 8 OUTLETS S 3 PARK $ 250. 00
()w)-lert III P IR T $ 39.00
fJ*.TAN PROPERTIE."S $ 9. 75
P0 BOX 6835 1151--'(,' $ 1. . 95
$ '1:32. 50
Al...OHA OR 97007 1i (a. 63
Pl-)ovip 0.-, 6455477 PAYM $ 250. 00 JLH 06,128/90
C,oiitrActor: 171 A Y M $ 1.418. 88 J L 14 0`a/1.0/9 W
TITAN P R C.)P E'R 7 1 E S
n B 0 X (,1:1X5
L 0 1-1 P 1)R 97007
It.. C.,45 C,4
130558
1708. 88 TOTAL
'his permit is issued subject to the regulations conta,oed in the REOUIRLD INSPECTIOMG
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/foLtnd Insp Phtnib 'Top Ot.0.
Applicable laws. All work will be done in accordance with approved Wtr Proof J.viq N FrAminq Iiisp
plans. this permit will expire if 4ork is not started within 180 Plost/BeAni Trisp Fireplace Irisl:)
days of issuance, or if work is suspen d tor more Wn 180 days. Crawl Draivi Gas L:tv.e lvisp
-:11ni/t.iii(Islab liisp Tiist.%1aH.(_1vi Tilsp
1-:1proli.ttee PI M/1.)i,l d er f 1 ot j r Gyp Board Iiisp
Ftrig Draj.ri Bsin' t Rairi drain Ivisp
S I't e d P Y. ........ Mec�hav)i.c,Al Trisp Water Livie Ivisp
Call for iiispectiaii 639-4175
wjr flwm
CITY OF '1*16ARD RECC-ip-r or-- r-AYMCWT
Rr--Crlr-7' NO. 90--2104665
IWE r 'l(04 PROPERTIES CHECk AMOUNT 14 10.801
#�DDRESS CASH AMOUNT 0.00
PAYMENT DATE 09/12/90
SUBDIVISION
.UHPUSE OV: PAYMENT' AMOUN'T f7'A I D PURPOcSE OF' PAYMENT AMOUNT PAID
(16) P-1-—IJ M-—DI NO-—fE-,F,(-M"- 1"32.'x,0
0ECHANTL;AL. PE 01. ST. BUILD rjrR 26. 63
PLAN LHECK F-C 6 0()
9. 75 STRrET 9DC
PAPKS SDC 250.
9'21(d SW PAT TI LANE
TOTAL AMnL;NT PAID 14 10. 0".3
SEWER CONNEG'TION
CITY®F TIGARD
P`E R M 1-T
�WYOFTWWAO', PERMI'T 14. . . . . . . .. SWR90-0.04
COMMUNITY DEVELOPMENT DEPARTMENT P R T r1l. P U R M 11 M S T';'Y'v) 0 0)G
13126 SW W1 Blvd. P.O.Box 23397,Tigiud,Orogon 97223 A 175
DATE ISSUEDc 06/28/90
S.11 ADDRESS. 8�-'10 ':)W V"A'111 LN PARCELS PS112CC-06900
S U D D.I.V TAG T()N. . . . I...A N G T R E E ZONING:
14 L 0 C 1/1. . . . . . . . . . . . . . . . . . . . . . . .. I
...........................
TA:NAN'T NAME::. . . . .
(PiA NO. . . . . .. . . . . 141674 F"I X'TU R E U N I I'S. . . I
("11 ASf.-3 OF:* WORK. . . »NEW DWELLING UN1`S. . .' J.
TYPE OF' LISE. . .. . . »SF' NO. OF BUILDINGS0
1.N S I'A I L TYl,l-:: . ., .— .DUSWR IMPERV SURFACE. . '.
14'o ni a-r k s P.
Dwrip-r: FEES
TYTAN PROPERTIES type ani 0 U 11 t by date -r e c,P t
P
[:10 14OX 6835 RM*T' $ 1250. 00
]:NSI! $ 35. 00
ALOHA OR 97007 PAY11 t 1285. 00 fl-1-4 0f.•,/28 9 0
rlhune 14,-. (-,455477
C('.)N'TRf-.0 TOR NOT ON FILL:
Pliarie #t i.28 5. 00 TO VA L
req N. . I
REQUIRED INSPECTIONS
This Applicant aGTPeS t3 comply With all the rules and regulations Sewer Jiitapec.,ticiri ........
..............................
of the Unified Sewage Agency. The permit expires 120 days from C a y;e I.-i I-)a I e(J ....................
the date issued. The total amount paid will be forfeited if the .............................-I..-..—.--,............
permit expires. The Agency does not guarantee the accuracy of the
side Sewer later. is. If the sewer is not located at the measurement
a7ven, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase ......................
2 ''Tap and Side Sewer" Permit and the Agency will install a lateral.
.......... .................
........... .................... .......... ...............
Y. ................................................................................................................... ......................... .............................................I...............
Call fo-r :irispeeticiii 639--•41'75
llF
F�zw ff
%..17Y OF TWA RD �`' . PLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT PLAN CHECK #
13125 S W Hall Blvd..P.O. ox 23397,Tigard,Omgm 97223.(503)6194115 PERMIT N
I l00 C) S ' Dfft
Joa PL)ARESS: TAX MAP/LOT 5/-
S U Ll L.IND USL:
'VA1-UAPION:
014N Rs* (o14 96-60or
SPECIAL NOTES
NAME: REISSUE OF.
ADDRESS: LAST REISSUE-:
FLOOD PL-AIN/
PHONE: 1-7 SENSIIIVL LAND:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME :
ENGINEERING:
ADDRESS:
ADDRESS: FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
BUIL-DLRS BOARD N: EXP DATE: 1-IST/SUBCONTRACTORS:
BUS TAX:
ARCH/LNGINEER CALCULA f fiiS
r--
NAM[ : TRUSS DETAILS:
ADDRESS: OTHER:
F114ONE:
COMMENTS:
SUBCONTRACTORS: PLUMB: ME-CH r
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL, DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
10- 431 01 Mechanical Permit Fees 12,
10-230 01 State Buil6ing Tax (5%)
Building IA10.5-
Plumbing
Mech
10 -433 00 Plans Check Fee 7
Building zl 0 ✓
Plumbing
Mech
30-202 00 Sewer Connection J2-5 a
30-444 00 Sewer Inspection 3.) J
51-449 00 Street System Dev Charge (SDC)
52- 449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Del, Chrg (SSDC)
10-230 06 Fire
TOW-
RVC N
6zz 7
APPEICANSIGNATURE
Received By: Date Received:
cn/3507P/I8P
s
Z ) -S.ilIOSI NJ (:(?N'F'ROL IN FORMA,I'ILL/N
GENERAL CONTRAC101% NAME& ADDRESS: CAST-TLE NO.:
PERMITNO.: —_--
APPLICANT NAME AND ADCRFSS:
EXCAVATION CONTRACTOR -__T-ITiq r1l4p'!
NAME& ADDRESS:
-JlLQllp - ljjL 9 ,100-1
OWNER NAME AND ADDRESS:
TEL;.PHONE NI)MBFRS:
APPLICANT- lF�"- CP11�1.� PROPER'T'Y DESCRIPTION:
OWNER 1-+�! - l 17�' STtf.kT AD ESS AIBP RO STRF TAMATEU�
GFNERAL CONTRACTC)R: 4,��_ -L li I
ck
EXCAVATION CON-IRACTOR-
SIIt/JOB�
LEGAL DESCRIPTION:
24 IIR/A1-TT-'R HOURS EMI-EGENCY TAX LOT NO.: _
CO • 'ACT PIiRSON, •I'I*IA;,TF-I,EPIIONE: 1/4 SECTION;
F� , SITE SIZE,ACRES;
-- — — - DISTURBED/WORK AREA, 'KRIS`
LOCATION& ADDRESS WHERE SPOIL S
LPAVINO SITE WILL BE TAKEN SITE RUNOFF DRAINS TO:(CIRCLE ONE)
(NOrI_:PERMIUS MAY w.REQu1RF.0) — CATE!-LIA51 DITCH PIPE CREEK
(CIRCLE ONE) PRIVATE - -Y
�PUIII,F_S.RIGIj (I WAY
ERQ51QN/SU1MF._ A-' _1.9N(,'QhjI:I.lQ LC�.SSI MI ASUBES
MINIMUM ESC REQUIRFMENTS MINIMUM ESC REQUIREMENTS
DIJRING CONSTRUCTION: 1:011 1)WING C'ONSTRUC'TION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZE-D CONSTRUCTION FNT RANCF P.FMOVE AND RESTORE TEMPORARY ESC
PERIMFT FR RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND RFMOVI? AI_I.SILT AND DFIIPIS
COVI-R PRA(l ICFS IiNSURF OPFRATIOrl OF PI RMANT FACILITIES
CONSTRUCTION SEQUENCE O1TIER_
OTI IFR
PLAN FOR EROSION CONTROi.PREPARED AND SUBMITTED IN ACCORDANCE WT!"H"TECHNICAL.GUIDANCE IIANDBOOK
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES CTJMPLETE,INCLUDING EMERGLNCY
PHONE NUMBER, s IIED(1L.EJS'TAGING FOR INS•TALLATF)N AND REMOVALOF EROSION CONTROL MEAS(JRES,ANL)
APPLICABLE S1 ANDARD N(YTES.
I IIAVE R5AD ANI)WILL COMPLY WITH THE ABOVE ANO WIe L CONSTRUCT AND MA114TAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON TILE CONSTRUCTION SITE.
OWNFR S)MATUR[i APPLE .NATURE
• • • • • • ♦ • i • • • • ♦ • • • • • • • • • • • • • • • • • • • • • • • • P • • • • • • • • • • • • • • • • • • • • • • * • • • •
01141 At,I1SE ONLY.
RECEIPT DATE A('Cl:l IT.D
FTE NUMBER RLCEIVED It Y