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11698 SW 125TH COURT-1 �i t� 3 CERTIFICATE OF CIWOFTIGA IW �� OCCUPANCY � G�k:RMI7 p, . . . . , . t MFrT90--0454 CITY OF( WARD COMMUN9TY DEVELOPMENT Ddr4hTfk+ T 0R DATE 1S5UEDa 11/21/91 131251 SW Hall Blvd. P.O Hm 2339,',Tigard,Or%,cm 97713(15W)fin-4176 SI TE NDI) 1698 SW 1.25T'N U r' - - PARCEL t t8133DD-416500 SUBDIVISION. . . . t VILLAOL A1• SUMMLRLAKE ZONING. BLOCK. . . . . . . . . . t LOT'. . . . . . . . . . . 1104 CLASS OF WORK. aNEW TYPE OF USE:. . . xSF OCCUPANCY GRP. tR3 OCCUPANCY LOAD2120 4 1'!�NAW NAME. . . x Remarks a Owr►ey't DON MORISSETTE PO BOX 19524 PORTLAND OR 00000- 0000 Phone M: 000 019 -i�000 Contractors DON MORISSETTE: BLDE:R59 INC. P 0 PDX 19524 PORTLAND OR 97219 Phone Nr 593-620-•7538 Reg M. . t 35533 Occupancy of the above ref(prenced building is he!rpby pitier►, and wertifiea the crimplianco with the S)A1,ate Of Oregon Specialty Codes far the grump, aectipancy, and urge under which the referenced permit w�,ls issued. FIRE DEPARTMENT BUILDING NSPECTOR /PUILDINO FFIC1 _._.. .- AL POST IN CONSPICUOUS PLACE: i - f i CITYOF TWARD PLAN ECK APPLICATION (r', rnrw-een / PLnN CHECK IV '�•5A COMMUN"DEVELOPMEITC DEPARTMENT / PERt1IT It /)1-5t nmsw.w.SpA.sm��,�.ao...,a•�rm.cs�lc>:��T DATE: ISSUED -;Ax rjAP/._oT JOB AOR S: )' C _ LAND USE: SUB: ALUATION: �2-''3� SPCCIAL NOTES OWNER fyl�( IS _I 1 L REISSUE OF: BaP�'41;5.3u NAME: LAST REISSUE: ADDRESS: o(;_ nil Q 51_ �7� FLOOD PLAIN/ n- 12C SENSITIVE LANO: PtME: - ' APPIOVALS REQUIRED i - PLANNING: CONTRACTOR ENGINEERING;: — NAME: FIRE DEPT _ADDRESS: OT11ER: ----- I_TF11S_REQl1IRED PHONE: _—.___ - — LIST/SUOOONTR ACTORS: BUS TAX: ARCH/ENGINEER ME: T�I G I IJK-� C•ALUCALCULATIONS:NA RUSS 01-TAILS: AOORESS. PARKING PLAN: ~ - LANDSCAPE PLAN: OTHER: PHONE: - PERMIT- N ACCT N DESCRIPTIONAMOUNT APIOUNT PD. BAT.. DUE a,ySq 10-432 00 Building Permit Fees — 10-431 00 Plumbing Permit Fees _ —� 10-431 Ol. Mechanical Permit Fees - 10-230 01 State Building Tax (5%) _ le Building Plumbing -� 3Y ✓ Mech / ✓ C)C' z c �A► 1033 00 Plans Check Fee, V 2 "/.' Building /f ; 3V C"Ay, Plumbing — Mech _ = ✓ / U�i cv -v 310 30-202 00 Sewer Connection 30. 444 00 Sewer Inspection _ 7� 51-448 00 Street System Oev Charge (SOC) ✓ ^c c' cy __•.�.-/ 52-419 00 Parks System Dew Charge (POC) 31-450 00 Storm Drainage Syst Oev Ct%rg (SSOC) 3 in-230 09 TRFO _ 10-230 06 Washington County rirc al (95x) — 10-220 00 nmart/Wedgewood �� � TU1'Al. RCC If . APPLICANT S1— Deceived By: _ v_ (late Received: INSPECTION NOTICE City of Tigard Building Department f` 13125 BN Ball Blvd. Tigard, Oregon 97223 Inspection Line (nec-O-Phone)t639 A175 Business Phone: 639--4171 Inspection: _ Footing Plbg. Underelah Mech. Rough-in L Appy/BdMlk./ Found. Plbg. Top Out Gas Line PIBALt Poat./Neam Strutt. San. Sewer Freminc -Bldg. Post/Beam Mech. Fain Drain Insulation -Plumb. Ping. Underfloor Water Line Gyp. Bd. -1tach. Date Requesteds Addraes:_��,•/ - ��J 1 �� _� Permit. 1t �� 9 Builder _._-.._ ✓-� __—_ THE FOLIkIWINC CORRECTIONS ARE REQUIRED: 1 Inspectors_ L-IjDates APPROVEb DIBAP ROVBD APPROVED SUBJECT To ABOVE Call Por Reinep. ■ ■ INSPECTION NOTSCE city of Tigard Buildinq Department t! 131.25 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rac-O-Pnone): 639-4175 Business shone: 839-4171 Inep-iction:�^_ -- Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing _, Bldg. ) Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requestedt / Ti.me: AM �_P14 Address: I/[Dq Permit Lf_ Builders 120-1 . - TAS FOLLOWING OORRECTIONS ARE REQUIRED: 61 tj Inspantort ---- --------- nates APPROVED niSAPPROVED AP:'ROVED SUBJECT TO ARWR Call For Reinap. INSPECTION NOTICE City of Tigard Building Departsb'-nt 13125 SA Ball Blvd.. Tigard, Oreqon 97223 Tnepection Line (Rec-O-Phone): 639-4175 Bunineee Phone: 639-4171 Foot inq Plbg. Underelab Mer_h. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line PINALt Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation L-P u Plbg. Underfloor Water Line / Gyp. Bd. -Koch. Date Requestedt a/�i11 .//- /,v n !�% Timet / Addreeet / ` Permit nuildert�tll /) I — THE POLLOWING CORRECTIONS ARE REQUIRED: 1 11-713 Inspectors _ _ Dates to APPROVED DISAPPROVID APPROVED SUBJRC. T TO ABOVE Call For Reinsp. jNSPECTION NOTICE City of Tigard Building Depart-went 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspections -- — -- -- r Footing /` Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. ` Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line �� Gyp. Bd. -Hoch. Date Requested: // //�'% Ste_ T PH Address:- 1L 'S Permit Builder: yn THE FOI.IOWING CORRECTIONS ARE REQUIRM -;�lJ� S -T/I !�f "�l��/l'C v�i�•9 //V�/A Lc.s`r� i-'.?���, tnepeatore ;� _, Dater APPROVrO DISAPPROVEt',/>—C APPROVED SUBJECT TO ABOVE Call i or Reinap. INSPECTION NOTICE City of Tigard Building Department P O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection -- Date Requester+11L—� r Time ------- A.M:,'44 P.M. Address --I�lr—L ----.�ry ,� �- ---_.------ Permit Owner .. - - _ —--- Lot — Builder ----- l`—fir-- —-- — The following Building Code deficiencies are required to be corrected: Presented to (PApproved Inspector / vU Diwpprovd Date, . UU ®�-1✓ - ..-.._ __. CALL FOR REWSPCC'TiON ❑ YES IPNO s W INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 l Phone: 639-4175 Type of Inspection j-, ��- Date Requested Time � A.M.--P.M. Address G z J � Permit �,`> " Owner Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to — � Rpproved Inspector _ [] Disapproved Date CALL FOR REINSPECTION YES 17 NO W1W1W1 i "Off HISTORY: VIEW UPDATE DELETE ESC View comments for selected item OAMASTER PERMITAAAAAAAAAAAAAAAAAAaAAaAaAAAAAAAAAAAAAAAAAAaAAAAAAAAAAAAAAaAASAaC :MST90-0254: PROJECT:VILLAGE AT SUMMERLAE: STATUS:I : UPD:10/16/90: :JLH: o PERMITTEE:DON MORISSETTE PRIM. . :MST90-0254: ° SITF ADDRESS:11698 SW 125TH CT oA CASE HISTORY AAAAAAAAAAAAAAA666AAAAAAReq/SentASchd/DueAEnd/DoneAAByAStatA6AC A705 Fout/found Insp 08/22/90 KS APP ` A707 Wtr Proofing Bsm't Walls / / Kg 4"14- ° A710 Post/Beam Structural 08/29/90 KS DIS ° A710 Post/Seam Structural 08/31/90 KS APP ° A713 Crawl Drain A717 PLM/Underfloor 08/29/90 TLP PASS ° A718 Ftng Drain Bem't Walls A720 Mechanical Insp A722 Plumb Top Out 10/05/90 '3S FAIL ° A722 Plumb Top Out 10/09/90 MS PASS ° A725 Framing Insp 10/05/90 KS DIS ° A726 Framing <REINSP> 10/09/90 KS APP ° A730 Fireplace Insp 11/01/90 KS APP A735 Gas Line Insp 10/12/90 KS APP ° A740 Insulation Insp 10/09/90 KS APP ° AAAAAAAAAAaAAAAAa.AAAAAAAAaASaAAAAAaAAaAaAAAAAaaA�5AAAAAAAAAAAAAAAAAAAAAAAAAASAi HISTORY: VIEW UPDATE DELETE ESC View comments for selected item SAMASTER PERMITAAAaAAAAAAASAAAAAAAAAAAAAAAAAA�iaAAAAAaaAAAAAAAAAAAAAA<iAAAAAAAAAC :MST90-0254: PROJECI':VILLAGE AT SUMMERLAE: STATUS:1 UPD:10/16/90: :JLH: ° PERMITTEE:DON MORISSETTE PRIM. . :MST90-0254: ° SITE ADDRESS:11698 SW 125TH CT " bA CASE HISTORY AAAAAA.AAAASAAAA&SAAAAAAAReq/SentASchd/DueAEnd/DoneAAByAStatAAAt ° A745 Gyp Board Insp 10/16/90 KS DIS A745 Gyp Board Insp 10/17/90 KS APP ° A755 Rain drain Insp A760 %later Line Insp A765 Appr/Sdwik Insp 10/18/90 CWV PASS ° A795 Mechanical Final H119 «O (4:51SNP ° A797 Plumb Final 11/19/90 MS PASS ° A799 Building Final aAAAAAAAAAAAaAAAtibAAAAAAAAASbAAaAaAAAAAAAA#aaAAAAAAAAAAk5AAAAAAAAAAAAAAAaA5AAai INSPECTION NOTICE , City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested —4c>U _ Time_L5 A.M. P.M. Addressff �T—��-j— l Permit WL2 —�.•�Sy Owner. Lot # Builder The foilowing Building Code deficiencies are required to be corrected: Presented to Approved In.pector +red Date CALL FOR REINSPECTION ❑ YEa 0 NO INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 A Type of Inspection Date Requested /� Tlme A.M._1L_P.M. Address _,!1:1- ,. _ Permit 44 Owner _ Lot # Builder The following Building Code deficiencies are required to be corrected: `' sr t�✓cry�iz` / I " i�F-y1Zr1 •-c=;f� A - Presented to _ Approved Inspector �, _ U Disapproved Date CALL. FOR RFUNSPFCTION ED YES 0 NO INSPECTION NOTICE City of Tigard Building Department �� P.O. Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection Date Requested___.. ��/ Time A.M.___ P.M. Address Permit� � -- Owner-. Lot # Builder ---..-- The following Building Coo deficiencies are required to be corrected: Presented to r jKApproved Inspector/,�C� Disapproved Date CALL FOR REINSPECTION ❑ YEs ❑ NO i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 ' Phone: 639-4175 Type of Inspection Data Requested �J 3 - �G Time15!'aZ&A.M. P.M. Address �� �� Permit Owner Lot # Builder �7 9 The following Building Code deficiencies are required to be corrected: Presented to _ / wtbproved Inspector ❑ Disapproved Date -� CALL FOR REINSPECTION ❑ YES 0 NO es s• w W ,■r M IN INSPECTION NOTICE City of Tigard Building Department P.O. Bcx 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Te- Date Requested ' � Q Time ___ A.M. P.M. Address v j� ---- — Permit Owner— ----J ) _._._._ Lot # . -- Guilder —�--= 1 -- --- - — — The following Building Code deficiencies are required to be corrected: 1 Presented to _____ _ Approved i Inspector __ FJ Disapproved Date CALL FO F'IMPFCTION YES 1—J NO S IISIWQ !AmMW-BW-M INSPECTION NOTICE City of Tigard Building Department P O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection L E t_� Date Requested O �� (�-- Mme/�—A.M.—P.M. Address ��� /c-�S ~ Permit Owner--_ _ Lot # - 7 Builder - The following Building Code deficiencies are required to be corrected: Presented to i _ Approved sv Inspector / Disapproved Date CALL FOR REINSPECTION YES 0 NO t � I INSPECTION NOTICE City of Tigard Building Department ,�- ✓ P.O Box 23397 Tigard, Oregon 97223 C Phone: 639-4175 Type of Inspection ✓ y _.___ Date Requested_ Time A.M. 701zJ Address /!� '7 / wl .� C _..__ Permit Owner Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to %pproved Inspector _ ❑ Diwpproved Date CALL POR REINSPECTION 0 YES Lu NO CITYOFTIGARD ,SEWER RMNI*r T IOM � 1�'ERMIr CITYOFTI6ARD FERM1T' ti. . . . . . . . SWR90-0.310 COMMUNITY DEVELOPMENT DEPARTMENT oReolc>N FRIM. C-'11 RMIT' T't. : MSI'90-.0254 13125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 9722;'!(503)689.4175 D A T'E ISSUED: 08/17/90 ��(:-rte-•a -- _ _ --- --- S I T'E A1)I)R1-H.55. „ « , ,,r' 4 1a 2b1*1•4 c, 1 PARCEL.: 1 S 13 3D1)-•-0' 6'500 51.)BDIVIf:iIOM. . . . . VTL.11GE SUMI'1F RL(1KI.:* IONINGx 1+1...001/1. . . . . . . . . . . I...C)l . . . . . . . . , rl'I�IANT' NAME. . . . . : USA NO. . A. . . . . . . . . . .. F"IX,TUI E� UNIT's. ,. . . CLASS OFWORK. . . :NEW DWI:::L_I._1NG UNIT'S. . -.1 'rYFE OF USE-. . . . . .SF NCI. OF' BL1ILD:IMGS: 1. I1,I5'FALL TYI''E . „ .. „ -J41JSWR 11711--'ERV SURFACE. . : Rvniil-rk.,: (J w rl a•r: ..._.__.._._.............._.__.._.._.__..._.........._..._......_....,.........................._...- _.._..... — - _._..............._ FEES DOM MORISSET'T'E type <xn)nt.t)It by (i,xte •rec.,pt: F'O BOX 19524 F'RI`i'r $ 1,`. 00. 00 1.N51=' $ :3Ei. 00 1::'01;T'L..AN1) OR 0 0 000 0000 I:''1•lYll $ 1,".53'5.00 J'I._M 08/1.7/'.0 I'�'11 c�1•l e N: pl El(%l-•H(�(d._.CSI H t•3(� �.iMT'RAC;TC)R I4C1T ON F':I:I_I:_ r•,x.,11 a. . . _...._.__..... REOU]'RE::D INSE'E.C;TION> lh>.s Applicant agrees to comply with all the rules ant! regulations Sewer J..rl!:,pec t;j.c)n of the Unified Sewage Agency. The permit expires 128 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the 1='F�r lu i.t t c�e 5 i.l71•l�i•L-t.t r F�« installer Lshall purchase genciYsa "Tap and Side Sewer' Derma and theral . .._......... __...._...__....__...._ ._..... __._........_._.._._... _ . _.......... I:s;s;t.t Fe(I D I Ctx 1]. -for 3.11 ipeet i c:lr1 t,'39 417`.; 19W-INUI CITYOFTIFARD MO.S)T E R PERMIT COMMUNITY DEVELOPMENT DEPARTMENT ITyOFTWARD PERMIT II. . . . . . . .. MST90, 0 2,5 4 omeooa PRIM. PERMIT #. - IIST90 0254 13125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 97223(6046.R4.1.76 DATE'. ISSUED: 08/1 /-/90 S7: TE (4 1)1)R L'S S. 44t" 5W I i2 b f H CT PARCEL: IS133DD-06500 SUBDIVISION. .. VILLAGE AT SUMMF*R L A K.E. ZONING: BLOCK. . . . . . . . . . .. LOT. . . » » . . . . . . . . : .104 BUILDING REISSUE:BUP892530 DWELLING UNITS.1 DASEMENI.. . . . . . . . :0 sf CLASS OF' WORK. cNLW BEDRMS:3 FA OT[A S.2 GARAGE. . . . . . . . . . 9400 sf 'T'YK'E OF' U S E. . . :SF* FLOOR RE UUIRED SETBACK$---_.------._..-_.. TYPE: OF CONS*T. c51q V,I R 1:1)T. . « . : 1.789 sf LEFT. . : 10 ft RIGHT. :5 ft OCCUPANCY GRP. .-R3 SLGOND. . . :0 sf F'RONT. :20 ft REAR. . :25 ft STORIES. . — -. 1. 'THIRD. . . » :0 sf REQUIRE D HE I GFIT. . . . .. . . . .20 ft TOTAL--------------. 1*789 sf SMOKE DETECTORS. IY F`L.00R LOAD. 40 psf VALUE. . . . . $- 82338 F'A R K,1.N G SPACE:S. 0 Renia-(4rs a PLUMBING SINKS. . . . . . . . . . : 1. FLOOR DRAINS. . . . r0 rAA(..Kl:rl-.OW r-'REVN*T'R';. . 0 LAVATORIES. . . . . :2 WATER HEATERS,. . . .' J. TUB/SHOWERS,, . . . '.G.'. LAUNDRY TRAYS. . . .0 CATCH BASINS. -.0 WATER CLUSETS. . :2 SEWER LINE (ft) . :0 GREASE DISHWASHERS. . . . : 1 WATER LINE (ft) . -. 1.00 OTHER F-1 X T U R E S. .. . ,. ., atl GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . -.0 WASHING MACH. . . : l (:;1:: RAIN DRAINS. . : J. MEC,'HANICAL FEES FUEL TYPES-) UNIT HTRS. . 90 type amount by date reept /GAS,/ VENTS . . . . . 10 PAYM $ 40.00 JLH 07/20/90 202950 MAX INPUT:0 P'T U VENT FANS. . 92 BPRT $ 382.00 FAIRN < 100K . . ol HOODS. . . . . . Il 14 P L 1, $ 40.00 TURN )-100K . . o@ WOC)DSTOVES. 10 B5PC $ 19. 10 FLOOR F*URN. . . . o@ CLO DRYERS. : I BPLC $ 30. 00 BOIL/CMP < 3HP10 OTHLER UNITS.-O STDG $ 600. 00 GAS OU*TLE.18: 1 SSDC $ 375. 00 Owner: P A R K $ 211750. 00 DON MC)RISSETTE. MPR T $ 33. 00 PO D 0 X 1.9524 11 P L C $ 8. 25 M5PC $ 1. 65 PORTLAND OR 00000--0000 PF-'RT- $ 117. 50 Phone "C 000-000---0000 P5 PC $ 5. 88 ContrAc.�tornn POYM $ 1822. 38 V"I L. 08/1'7/90 DON MORISSETTE BLDE.RS, INC. P 0 PDX 19r.'j24 PORTLAND UR 9721.9 1:.Ih(-.)ne #c 503-620-7538 Reg #. . # 35533 ....... $ 1.862. 38 T_04 AL. This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS liqard Municipal Code, State of Ore. Specialty Codes and all other F'uot/1`0U11c1 Insp Meeh anical Insp applicable laws. All W0Tk will be done in accordance with approved Wtr Proofing Bsm PIUMb Top OUt plans. This permit will expire if work is not started wAhin log Plast/Beam StrLtUt F'-rAminq Insp days of issuanco, or if work is suspino!d fAV days.. Plost/Eleani Mechan Fireplace Insp Crawl. Drain Gas Line Insp ...... PlM/Undslab Insp Insulati.on Insp PILM/Underfloor Gyp Board Insp IssLted by -." Ftng drain Bsmlt Rain dran Insp Ca1.1 for :inspection 639-4175 - -TTY OF TICAPD PECEIPT OF PAYMENT RECEIPT NO, e 9(.:) D",3 061 CHE(*-'I,,* AMOUNT 5? 8 NAME x DOt,,l MOR ISSE'Up- CASH AMOUNT a c.).()(I ADUPESS PO E,OX 195r.'i'N PAYMENT DATE' a (:)E);' 17/9(.:) PORTLAND. OP 9 72 1P V AT SUMMER LAVE F-URPOSE OF PAYMENT AMOUNT PAID PUPPOSE OF PAYMENT AMOUNT' PA 1.P POILDINIS PEPH '02.f FLUMBIPili PERM 117.50, IIF.CHAI,JicAi- rs c)(:,) ST. PLITLD PEP,26.6 PLAN CHIECI, FE 'e'25 SEWER UrA Of) SEWER INSPECT ~M. 60 STREET SDC 6(.)(:,.Oct PAP .;y SOC 2 5 STORM DRAIN SDC' .1014L. AMO(jt,.JT F,Atb -,p It 1w M OF rm �,�An1nc�L:R()sloN Ct)N'1',tUl ,N,•�Jlin�n 1 1�1� GENERAL CONTRACTOR NAME& ADDRESS: CASEFILE NO.: PERMIT NO.:— I L ;. r" ` ;1 ' — APPLICANT NAME AND ADDRESS: EXCAVATION CONTRACI-OR Lt Ldp• �;i -1, ! NAME& ADDRESS: ! i i i c ! < 1 tL � +;� 4 ` OWNER NAME AND ADDRESS: TELEPHONE NUMBERS: PROPERTY DESCRIPTION: APPLICANT - + 1 1` t t 1` STREET A DRESS AND CROSS STREET/LOCATED OWNER• `, .}� c 'lt 1 .t�Zt -- GENERAL CONTRACTOR: ,i a 1 %� �_c l i i I'`t ����,i�•l �r� EXCAVATION CONTRACTOR:i SITE/JOB LEGAL DESCRIPTION: 24 HR/AM- -R HOURS EMERGENCY TAX LOT 1/4 SECTION:NO.:_ CONTACT PERSON,TITLE,TELEPHONE: SITE SIZE,ACRES:_`7C'`•%? DISTURBED/WORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS SITE RUNOFF:DRAINS TO: (CIRCLE ONE.) LEAVING SITE WILL BE TAKEN CATCH-UKS'IN DITCH PIPE CREEK (NOTE:PERMITS MAY BF.REQUIRED) h _ (CIRCLE ONE) PRIVATE PROPERTY_ OLIC RIGHT OF WAY EROS IO NIS EDIMENTATI Iv_ (��r�1'ROl_ (ESC'1 MI:ASURE� MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCITON: FOLLOWING CONSTRI ICTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC PERIMETER RUNOFF CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILiTIGS CONSTRUCTION SEQUENCE OTHER OTHER _ -- PLAN FOR EROSION CONTROL.PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK-. EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY PHONE NUMBER, SCHEDULE/STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND APPLICABLE STANDARD NOTES. I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SEDIMENT ON TILE CONSTRUCTION SITE. _�P— OWNER SIGNATURE — APPLICANT SIGNATURE • • • • • • • • • • • • • • • • • • • • • • • • • • •UITICIAL USI. ONLY. • • • • • • • • • • • • • • • • • • • • • • • • • • • RECEIPT DATE ACCEPTED FLT. NI_IM11ER RECEIVED BY 1 ' P.O.Bax 19524 Portland,OR 97219 (503)244-9314 Sc ALZ 1 -2o PtA N * 16 (VI A cp,.) TL W Ct�l7 k rJrY 1 F I RE Pi-✓)c L. F//Z "Co �+at3 NE s 9 La T I0- UIU_AGe AT Su+wimd� r,, I C 17 0 Tl,, 04/: 0 4Z-5-ZS'- S tN 12 S C7 Coin,-y �,PPk'ol�,c ti. C(INCRL71� \\ 4�. �A? n � VI �\0 S i 40e'� — LDouLO cic tr G F I o?S 1789 ACL, 090 z z r F e -101 l 1 I � PA10 i 1"UUrpf� tir w+r.� c D vufL fry \'�c/ �•T la1 f�2� '��' � — ----- l04 7088° su