9564 SW SATTLER STREET 9564 SW Sattler St.
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CEPTIFICATE OF
CITYOFTI(FARD CffyOF,Imm) OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT rIIY4 PERMIT #. . . . . . . i MST90--0299
13126 1SW HWI BW. P.O.Box 2M97,Tigard,Oregon 9=(SM)630-4175 --0*60*14-
ISQ-164),
:3IT,:" A D D R E G). . . 9564 SW GATTLER ST PORCELi 25111CA-11100
'SUBDIVISION.. . . . : LAKFSIDE PLACE. ZONIN(lo P-7 PD
131-Ock. . . . . . . . . LOT.. . . . . . . . . . . . .
CLASS OF WORK. :NEW
TYP6 OF USE. . . SF
OCCUPANCY GRP. R3
OCCUPANCY LOAD:E'20 4
'TENANT NAME. . . s
OELVIN WAYMIRF
10845 ��W DOVER CT
TIGARD OR 9722.�4
Phone 4- 5@3639674,-'
Contractor:
MEL.VIN WAYP;!Rr.,
021845 SW DOVER CT
OR 97224
IF: 5036396742
Req . * 35976
Occupancy of the shove rpferenced bUildilIg iS hPrp-by given, and certifies
the c-,omplianct with thi- 9)taLe Of Or914011 5'p0Ci,41tY (:0d(*S for the group!
0Uc1A1)41l1Cy, And L14e under which the reFc-revicpt) permit was i %sueci-
-RiRFNT - ----------
FIRE Ht I il-6i'l INS_P"TOR
P Ll I L NC0r-0 r I AL
P01-)T TN CONS)PICUOUG PLACE
- W- 0 0 1
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:, --
Footing Plbg. Underalab Hoch. Rough-in Apor/Sdwlk
Found. Plbg. Top Out Gas Line FINAL
Post/Beam Struct. San. Sewer Framing ,--Blig.
Poet/Beam Mech. Rain Drain Insulation C -Plumb.
Plbg. Underfloor Water Line G}lv. Bd. -Mech.r
Date Requested: L C _ Times /7
Address, Q` ' Permit 3:�4' Com, l
Builder: L'U�L � J
THE FOLLOWINO COR , TIONS ARB REQUIRED:
.SAN] HP ri, CU r.LC
I nspector:-_— ^-- ---�.. Date: 7"-
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
1NSPEM7)N NOTICE
City of Tigard F.vilding Department
13125 SM Hall Blvd_ Tigard, Oregon 97221
Inspection Line (Rec-O-P ne)• 639-4175 Business Phone: 639-•4171
Inspections
Footing Pit Underslab Mach. Rough-inAppr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plby. Underfloor Water Line Gyp. Bd. -Mech.
1� 1
Date Requested: -141- / � _ Timet _AM --PM
Addresst e y
Permit f:
Builder:_
THE FOLLOWING CORRE�RA REQUIRED:
c /—p
Inspector: Date: S_ �
APPROVED DISAPPROVED - APPROVED SUBJRCT TO ADOVF.
Call For Reinsp.
I�iS�BCfIG:1 NOTICE =`
city of Tigard Building Department
13125 SN gall Blvd. Tigard, Oregon 97223
Inspection line (Rec-O-Phone): 639-4175 Business Phone: 63"-4171
Inspection: _-- v--
Footing Plbg. Underslab Mech, Rough-in Appr./sdwlk )
Pound. Plbg. Top Out Gas Line F1NALt
p-ist/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Meet. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Linev/7 Gyp. Rd. -Mech.
Date Requesteddttf Timet _ , AN �,_ PM
�&A
Address: / — Permit #t
builder•
TItR FOLLOWING CORRECTIONS ARE REQUIRED:
Or
Inspector: � ✓ - ,
APPROVRD DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call Fcr Ra)nep.
I
7
ti �N—pE�:i ION ItY1�B i
City of Tigard Luildiag Department �/jj
13125 SN Hall Dl.rd. Tigard, Oregon 97243
Inspection Line (Rec-O-Phone): 639-4175 Business Phdnrr
Inspection:—
Footing
nspection:--- ------Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line yp. Bd:i -Meeh.
Data Requested:__ f;z- / ^0 _ _Time- /� J1M QGPM
Address:— L Permit
Builder:_
THE FOLLOWING cMRRE IONB ARE REq:JIRED:
i
Date.,..
APPROVED ,— DISAPPROVED — APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE }
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rer_-0-Phone): 639-4175 Buninese Phone: 9- 71
Inspections
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post./Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Rerpsented: — __Times _—`AM PM
Address: L Permit i: . � �- (L/�c?
Builders
THE FOLUMINO CO IONS ARE REQUIREDs
Inspector:
APPROVED DISAPPROVED v APPROVED SUBJECT TO ;.BOyE
For Reinnp.
INSPECTION NOTICE
City of T'igani Building DeparLxwnt
13125 ASN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Buoinees Phonel. 39-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-ipJ Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Pust/Beam Struct. San. Sewer. e'raming �� -Bldg.
Pont/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date kequestad: ZIV"I
- Times AM PM
C:;7
Addreent � L ' Permit f:
Builder:
THE FOLLOWING CORRRCrIONS APR. REQUIRED:
Inspector:
a Date:
V APPROVED _ _ DISAPPROVED APPROVED SUB.TRC'1 TO ABOVE
----Call For Reinsp.
NI SP—Ea gN_NOTICE
City of Tigard Building Departa.ont
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Ruainess Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. ,/�P1bg�Tpp outGas Line FINAL:
Post/Beam Struct. Sar:. Sewer Framing -Bldg.
Poet/Beam Hoch. Ra Li Drain Insulation -Plumb.
Plbg. Underfloor Water Lina Gyp. Bd. -Mach.
Date Requested:_C
Tlma: n__AM _.._-PN
Addrsas: `�J4� Permit is_!� Qa.Z�1
Builders
TER TOLDWINO C046CTIGINS ARS RNWIRRDs
r
v
Inspectors
Date:
APPROVED OIAAPPROVED APPROVED SUBJECT TO ABO
Call For Reinnp.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection .� , y - 6f", 11-g-521
t-"
Date Requev.ed_ _ Time A.M. P.M.
Address .__ .���f.Z _ Permit
Owner - _ — Lot #
Builder .--- ---___ -- - -----The following Building Code deficiencies are required to he corrected:
P,esented to _- L AG Ale oviod --
Inspector ❑ Diapproved
Date
CALL FOR REINSPECTION
L=1 YEIS 0 NO
INSPECTION NOTICE
Cit; of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 7223
Phone: 639-411 75
Type of Inspection
Date Requested 11me A.M. V P.M.
Address es111 L Permit #?-1:2
Owner Lot #t
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ Approved
Inspector _ U Dlgpproved
Date
CALL FOR kEECT O
0 YES (A NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard. Oregon 97,223
Phone. 639-4175
Type of Inspection ---����4%'LT -� �. �--�-a
Date Requested ) 7Time T A.M.,----P.M.
�l a /'
Address �.5�� ,.cGk-c Permit
Owner Lot #
Builder _--- - - -
The following Ba(ding Code deficiencies are required to be corrected:
Presented to - _ _ _-_�_ fr 11 Approved
Inspector u Disapproved
UatP.
CALL FOR REINSPECTION
0 YES 0 NO
W WR
INSPECTION NOTICE �ScK
City of Tigard Building Department 7/
P.O. Box 23397 -�/� N
Tigard, Oregon 97223 R�
Phone:z
1 '
Type of Inspection `-'� '� L-P.M.
Date Requested �, ( ____ Permit
Address --�=
Lot # —
Owner
Builder r•�f'j�/.t . — — -
The followinu Bdilding !:ode deficiencies are required to be corrected:
Presented to — 4 Approved
Disepprov^d
Inspector �..
Date
CALL FOR REINSPECTION
❑ YE& 0 NO
MASTER FIERMIT' V
PERMIT ##. . . . . . . . 11 S'T`�0••-0i?99
CITY OF TIGA RD CF�aFTWARD PERMIT ,. .-•0299
PRIM. FI�F,ihIT #i, : MST900299
COMMUNITY DEVELOPMENT DEPARTMENT oaeoow DATE: ISSUED: J.0/05/90
1.1125 SW Hall BW. P.O.Baa 23397,Towd,Or.pon 9 223(t03)W9-1176
I. f i.:. ridl,UKi.;i1:i» , » : 'i)'iE'4 SW SATTLER ST PARCEL: 2S111CA--LSP02
'at.11:DIVISION. . . « : I_AKE.SID1= FILA[,I-. ZONING:
1.11...0C.K. .. . . . . . . . . a LOT. :2
_._ ._..__.._ . ._._...... H U I L D I N C; _._..._._._.._.__._.._.._.....___._.._. .___._.._.._..._ _._._....._...... .._.._........
r2F ISSIJE:. DWELLING UNITS: 1 BASE:MEN'T. . . . . . . . 90 s•f
(LASS OF WORK. :;14EW HI:DR11S.4 BATI.113:3 GARAG1*:. « . . . . . . . . .418 s'r
TYPE OF USE. . . FLOOR AF<E:AS_._.._...._..._._._.._._. RF OUIhF�'D SE"TRACKS•-•-••-•_•-•••.-•._._..
TYPE OF CONST. -.5N FIRST. « » » :953 S LEFT. . -, 7 ft: RIGHT. :5 f l:
Cl(::CUPAN4 Y GRP. :R3 SECOND— :885 sif FRONT. -.30 ft REAR. . 999 ft
STORIES. « » » a2 'THIRD. , » .C� S R E 0 U I R E ---- - _....-_..._.._.-_.._..._._.
11E'lCi HT. . . . . . . . ..20 ft TOTAL•.••-•.-._.-•••`•• 18:38 s'F SMOKE DETECTORS. :Y
1:71-OUR L.OAD. . . . 940 P--,f VALUE. . . » aP..072 PARKING SPACE S. » :0
Remail•%s:
_ ....... _..._...-•-• PLUMBING ___......_._.•.._._._.__.._._._.__._____.__.______ _. ____...
SINKS. . » . . . . . . . • 1 FLOOR DRAINS- - - '-0« . .id BACKFLOW FIREVNTRS. . :0
LAVA'T'ORIES. . . . « .4 WATER HEATERS. . '] TRAPS. . . . . . » . . . . . . . :0
TUB/SHOWERS. . . . :2 LAUNDRY T RAYS. . . :0 CATCH BASINS. . . . . . . VO
WATER CLOSETS. » :3 SEWER LINE:. (ft) ,. :0 QREASE TRAPS» . . . . . .. a0
DI:SWWASHEi.Fi1�« . . » . :I. WATT: R LI:NF•r (ft) --. 100. OT'HE R 1=TXT'URI:S» »
GARBAGE DISE» « » : :L RAIN DRAIN (ft) . -'O
WASHING MACH. . » : J. 131" RAIN DRAINS-, » : :1.
MECHANICAL ...._. ._. _.___........__._.___-__.._..___ FETES ._._.._____.......___.,..
FU FE.L.. TYPES- ` -- UNIT HTRS. . .0 type amcau1•1t by date recpt
/GAS/ / / VENTS . . . . . 10 PAYM $ 100. 00 JL.H 08/31/90 2V '.,-'
MAX INT''UT.O BTU VENT FANS. . :4 BPRT $ 412«00
F URN ( :LOOK » . : :I. HOODS. . . . . » .. 1 BFII-(11 $ 267. 80
I"'lJF1N )�•100K « » .0 W00DSTOVE:.S. :0 Ic51''C $ 20. 80
FLOOR TURN. . . . :0 C:LCI DRYERS,, ^ I s I'DC $ 600.00
icf:lll.../CMF' ( 3HP:O OTHER UNIT :0 SSDC $ 375»00 J /
GAS OUTLETS: 1 PARK $ 250» 00
ME*L.VIN WAYMIRE. PL-(I It 9. 75
I (1H4�7 SW DOVL:.R C.T 1111e1�( $ 1. 95
P1:,kT $ 140.. 00
T 1:CaAF�I) OR 97R24 V:I5 P(,I $ 7. 00 / !
Phone ##,. 50363'36742 F'0Y11 $ 2023. 10 JLH 10/05/90
Cc111 t r a c�t ra•r,. __-__...._......._.._... ......,._........._..... ....... ........_.._.._....._....
MFA..VIN WAYMIRE
1.084t) SW DOVER CT
T:I:GARD OR 97224
C:'hc),le ##: ""50363'•. 6742
Req 0. . v 35976
$ 21.2;3» 10 TOTAL
This permit is issued subject to the regulations contained in the -- - •~•... REQUIRE::D INSPE.'C:'TIONS -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Fr.ot/faurld Ir1sp Mechanical Irmp
applicable laws. All work will be done in accordar a with approved Wtr Proofing Bsm Plumb 'Top Ot.1t
plans. This permit will expire if work is not st >ed within 189 Pr_
Post./Beam Strut: F'raminq Insp
days of issuance, or if work is suspe d fur eo s, than 14 drys. Patt/Be,.Am Mecharl Fireplace Ir1sp
/ C:•r a w 1. U•r a i.1-1 G a 11; L..J.1.1 e 111 T,p
1'ermi.ttee 1,i.gnature( _. .. _... P1.m/1.1nc1i:;l.,vb Trisp Ivist.11ati.an l:nsp
Z,/d, . _._. ....
PLM/Underfloo-r Gyp ''-+aid Insp
1 ssl1ed I' F"tnq Drain F.1sn1' t Rai ' ai.r1 11-1!5 1.,
Call. fa-r 639•_4.1.75
LiF W L.R C 0 N N LC'TI 0 N
5— I..,L R ITI I T,
CITY OF TWA RD PER11140. . . . . . . .. SWR90-0352
CMOFTM
C171D
COMMUNITY DEVELOPMENT DEPARTMENT offew VIRTI'll. PERMIT Ii.
131258WHWI Blvd.P.O.Bcw23397,T1pW,Ov*pon 9*40(SWISWI75 DATF.': ISSIR D.-, 1.0/0`5/90
(-)DDREGA . . . :: 9'564 S14 50 T'I'LER ST
5IJBDIVISION. . . . .- LAKESIDE PLACE. ZON ING s
L'i L.0 C K.. .. . . . . . . . . ... LCIT. . . . . . . . . . . . . ..2
........... ..........— ..........
I* P NAME':. . . . . .
N(:1.. . . . . . . . . . .42397 I-'J X'TLJ IR E IJ NI T S
I (.)S(,: OF' WORV,., I
N[7.W D W E—L.1:N(3 (J 14 IT'S.,
'T'Yl::,E OF USE SF' NO. Of-- PIJILDINC'-)S.- 1
INSI'M L. -1-YI-:111. BUSWR IMI-'F. RV SI.JRFACE. f
R e n1a.(,k Ei
III*;,L.V I*14 W()Y11 I R E t;Y 1:)f-, anIOLI)lt f)Y (late -r e c pt
1.0845 SSW DOVER C'111' PRMJ 1500. 00
1:11 f,)P 1, 3S. 00
1(3 AR 1) 0R 97 224 11()Y IVI 1 1."'.53".5 00 J I )--1 1.0/05/90
VII-if--)rie 0.- 503(:,-396'?42
('01,1TROCI-OR N01' ON
I?Iif7rie tis 1535. 00 C)T P L
.................. RL(.4(.JIRED T N 131.*:1 E C J'I 0 11 S
'his Applicant agrees to comply with all the rules and regulations Sewe-r
cif the Unified Sewage Agency, The permit expires 120 days from
..........---............................
the date issued. The total A000-t paid will be forfeited if the -------...............
pRreit expires. The Agency does not guarantee the accuracy of the .......
side sewer laterals. If the sewer is not located at the measurement
PIM, the installer shall prospect 3 feet in all directions from
the distance given. If not so located. the installer shall purchase
"Tap and Side Sewer" permit and the AWcy wil in tall a lateral.
(-'r in i.t t e e S j.i ri a t,i.i-f,e
. ........................................... ...............
I ioi ii t.t(i d B
Call fo-(, iiispe(-ti.oi-i 639 41 75
GITY OF T113ARD RECEIPT OF PAYMENT RECEIPT NO. s 90-•:205'510
CIAECI,*,' AMOUNT s ,*5'x(3. 10
NAME MEL., WAYMIRE CASH AMOUNT p Q.00
ADDRESS a PAYMENT DATE o t0/05/90
SUBDIVISION
T.1 C;A F,'1).0 R 97223- 9564 SATTI-ER
1"URPOSE OF F'AYMENT AMOUNT F`AID C'URPOSE OF PAYMENT AMOUNT PA 11)
T,16-1 Lb' I N-6—PE-1 k—M—M-6--T 9 0-(12 9 9 41.2.00 PLUMBING PERM ._-1 Q`:
4("'. 00
ME C'HAN I CAL PE -9.()() ST. BUll-D PF.*.'R 2 r.SZ!
PLAN CliErl!' FE 177.555 ';EWER USA 00
SEWER INSPECT 35.oO STREET SDC 600.00
"o.(10 GTORN DROIN SDC
r-'Ard-1:S SDC 25 175. 00
'TiT'Al, API(JUNT PAID 311550 10
W
e
111 ' OF TWA RD, ,3,2O Bo 14011 PLAN CI� if AM ON
P.O.Box 23397 PIAN alDac, iipo,d Gkogon 97223 PE7�r U
TJ4' (503)639-4171
COMMUNITY DEVELOPMENT DEPARTME DATE ISSUED
JOB ADDPESS: q5 IR S.W. sa t-t 1 o r�St- TAX MAP/LOT z1,�L�� =_ALE d 3
:EJB: Lakeside Place is��_ _ LAM �F= --
T VAUTATION: _ � s -----
OWNER SPDC'IAL NO►If
NAME: Melvin G Waymire, Jr. _— ____ 1ZU.139j'E OF: _
ADDRESS: P.0. Box 231164 LAST RL7SSUE: ---- --
—
Tigard, OR 97 2 FLOW PLAIN/
---- SENSITIVE LAND: _.
I TONE: 639--6742 _-- --
AI''f'�2CNALS.RDQUlI2FI)
CON"MCMR PLANNING:
NAME: _ Melvin G. J r. ENGINE RYNG: ^---
ADDRESS: P.o. Box Z 3116 4 FIRE DEPT
-- - Tigard OR 97223
1410NE: 639-6742 ITEMS 1 'IFMA
BUILDERS BOARD 1: 6 EXP DATE: / • _
BUS TAX:
ARai/ENGINEEIR CAIOJIATIONS:
NAME: Alan Mascord_ _ -- TRLES DETATU,S:
ADDRESS 1515 N W 23rd-Ay-p—-- cofER: --
---- PoLj and,, QR 'l7)i n ---
111ONE: - - -
S[MCO PRACIURS: PUMB: Ken Watts P,1umbinc,t MECH: e�
�T TtiC, G 1(
I'IIdhTT ,f AOCr f DESCRTPTIC N AMXW AH"r PD. BAL. DUE
10-432 00 Building Permit rbcs ✓ '.� �' �` v c
10-,431 00 Plumbing Permit Fees / c l �
- 3.0431 Ol Medvknical- Permit Fees 3f. v - 39, f o
--- 10-230 Ol state Building Tax (5%-) Zy,S S - ;5
Building
Plumbing
ren
in-433 00 Plans Cheek Fee Z�7
Building
Plumbing
N'lodt ;7_)
`i �jU y,0 35230-202 00 Sewer Ommection
30--444 00 Sewer IrsPectian
51-448 00 Street System Dev C3Orge (SDC) _ u
52-449 00 Parks System De-v Chartle (PDI;) —.25c)
31-450 00 Storm Drainage Syst Dev Clrg (SSDC) 373
1.0-230 06 Fire_
TDL'AL 355 , /p
1 1 RW.
APPLI SIC�iAT
Received By., Dane Reoeivod:
of/3587P.WPF ---- - - _—
GRADING/EROSION CONTROL INFORMATION
GENERAL.CONTRACTOR NAME.&ADDRESS: CASEFILE NO.:
Melvin G. Waymire, Jr. PERMIT NO.:
gar , 0& 9 7 2 2 3 - APPLICANT NAME AND ADDRESS:
EXCAVATION CONTRACTOR Melvin G. Waymire, Jr.
NAME& ADDRESS: V.0. LnK )-Al i A 4,
_ Lonnie Endicott I)umptrucking
1'iaard. OR 97223
21320 N.W. Moores Va 1 1 r,y Rj. OWNER NAME AND ADDRESS:
Vamp i 1 if Clu --
TELEPHONE NUMBERS:
APPLICANT: 639-6742 _ PROPERTY DESCRIPTION:
OWNER; _ STREET ADDRESS AND CROSS STREET/LOCATED
GENERAL CONTRACTOR: 639-6742
S.W. Sattler St. , Tigard
EXCAVATION CONTRACTOR: 245-7646
SITI:/JUII:
LEGAL DESCRWJ'ION:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO. #3 - Lakeside Place
CONTACT PERSON,T rME,TELEPHONE: 1/4 SECTION:
Melvin G. Waymire, Jr . SITE SIZE,ACRES: 5580 su. Pt '
DISTURBED/WORK AREA,ACRES: 9580 Sq. F t.
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITLRI,INOFF DRAWS TO:(CIRCLE ONE)
(NOTE:PFRMTIrS MAY BE REQUIRED) C CATCH-BASINJDITCH PIPE CREEK
None a3Ltlr i -wa tod
(CIRCLE ONE)4RIVATE PROPER'T'Y`
PUAL,IC RiZ;AT'�F' VY
ERQSTM �D�1: IME ATION CONTROL (ESS MEASURES
MINIMUM ESC REQUIREMENT'S MINIMUM ESC REQUIREMENTS
DI WING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTIZUCTION 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 FACILITIES
CONSTRUCTION SEQUENCE OTHER _
OTHER
PLAN FOR EROSION CONTROL,PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK".
FROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE.INCLUDING EMERGENCY
PHONE.NUMBER, SCHEDULFISTAGING 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 NEC .56ARY
TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE.
OWNER SIGNATURE _ APPLICANTSIGNATURF:
(ATIC LAI I LSF_ONLY
RECEIPT DA I F ACCEPTED
F f?G NUMBER I?[ f ivLl) BY
CITY OF I'MARD - REX XIPT M PAYMENT RECEirr NO,. 2 90--2043()7
CHECK' AMOUNT v 200.00
WAYMIRE, MELVIN CASH oMOtJN'l* 0.00
ADDRESS PO BOX 231164 PAYMENT DATE 08/'_'1/90
SUBD I Vl Fi I ON
TIOARD, OP 97223
rURPOSE OF PAYME'wr AMOUNT PAID PURPOSE OF FAYMENT AMOUNT PAID
r,H E C57 HE 4R 7)o 100.
LCYT #2 AND LY #7, PI-ACE
RITAL AMOUNT PAID 200. 00