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8372 SW LANGTREE STREET r f 8372 SW LANGTREE STREET _. r.r w w CERT IF ICAI L [OF CITY of T167ARD CWOF TWARD I "f'JPf�NC Y COMMUNITY DEVELOPMENT vEPARliMfsl+FT �asoa+ PERMIT i►. . . . . . . s MOT90-0106 13125 SW Hall Blvd. F.n.Bar „23397,T-Wrd,CWwjon 9 %Wy#3P 76 \ ITE ADDRE.! 8,372 aW L7N0'TREE,. ST PARCELS x'!311k?CC 09'.00 SUBDIVISION. . . . s I_ANG) REE ZONIN6s 8Ll?CK___._____. LOT____.____ ._.._..s ie7._._._..... __..___...._. _..__. .____...__________ CLASS OF WORK. s NEW TYPE OF USE. . . s SF O('CUPANT"Y CARP. s R3 OCCUPANCY LOPD1220 4 Tf:N"J.'T NAME. . . r Remcarks 0 Owners TITAN PROPERTIES PO BOX 08313 01-0II0 OR 97007 Phone Ns 6455477 Contractors TITAN PROPERTIES PO BOX 6835 ALOHA OR 97007 Phone Rs 645 . "77 lie M. . t 3015, ;A Occupancy of the above referenced building is hereby given, and r::rtifie,a the compliance with the State Of Oregon Specialty Codes for the group, occripancy, and use unde►, which the referenced permit was issued. F i R DEPARTMENT F►LII Nth I h19P CTOR POST IN CONSPICUOUS 6)(._ACE ., ■e wit ww �. a[, ar .r Delete selected .item 6a!9ASTER PERMITfi$fififififiAfifififififififififihfififiAfifififififia.afifififihfifififififififififififiAfififiafiAAfififififififiC :MST90-0106: PROJECT:LANGTREF STATUS:F UPD:12/19/90: :GES: ° ° PERMITTEE:TITAN PROPERTIES PRIM. . :t!FP90-C1.06: SITE ADDRESS:8372 SW LANGTREE ST Ofi CASE HISTORY fiA&A&ftA&&&Ah&&&&&Ahhhh&&Aeq/SenthSchd/Due$End/Doneh&By&StatfififiC ° A722 Plumb Top Out 09/04/90 TLP PASS e A722 Plumb Top Out 09/26/90 MS PASS A725 Framing Insp A730 Fireplace Insp A735 Gar Line Insp 10/02/00 TLP PASS A740 Insulation Insp 10/12/90 TLP PASS ° A745 Gyp Board Insp 10/16/90 TLP PAS: ° A755 Rain drain Insp A760 Water. Line Insp ° 765 Appr/Sdwlk Insp 11/07/90 MM PASS 96 Mechanical Final 12/19/90 GS APP A197 Plumb Final 12/12/90 TLP FAIL ° ° A797 Plumb Final 12/19/90 MS APPR ° A799 Building Final 12/19/90 GS APP A070 Case Fi_naled 12/.19/90 GS APP ° afifififififififififiefifififiAtfifiafififififififiAAaa, :aAfiafiAAfififiafiafififififiAfififififififififififiAAfifi�.i&gAiAfiiAl HISTORY: VIEW UPDATE DELETE ESC Delete selected item 1 6dMASTER PERMI'1'afiafififiAfifififififififififi3AafifiafifififififiAAfififififififififififiAfififififififiAAfifififi.,AfififififiC :MST90-0106: PROJECT:LANGTRE'.3 STATUS:F UPD:12/19/90• :GES: PERMITTEE:TITAN PROPERTIES PRIM. . :MST90-07)b: ° SITE ADDRESS:8372 SW LANG".'REE ST ° 6A CASE HISTORY &&&&Ah&hhhhh&666 `AAAAAAR-�q/SentfiSchd/DueAErid/DoneA6..ByAStatiiAC A722 Plumb Tup Out 09/04/90 TLP PASS ° A722. Plumb Top Out 09/26/90 MS PASS ° A725 Framing Insp ° A730 Fireplace Insp A735 Gas Line Insp 10/02/00 TLP PhSS ° A740 Insulation Insp 10/12/90 TLP PASS A745 Gyp Board Insp 10/16/90 TLP PASS A755 Rain drain Insp A760 Water Line Insp A765 Appr/Sdwlk Insp 11/07/90 MM PASS ° A795 Mechanical Final 12./19/90 GS APP ° ° A797 Plumb Final 12/12/90 TLP FA?i, Pi97 PlurO) Final 1.2./19/90 MS APPR ° A'199 Building Final 12/19/90 GS APP A97G Case Finaled 12/19/90 GS APP ° aaaAfiAfifififififififiAAfififiSfifiaafifiaafififi�3AAAfiafiafifiafiaAAaijAAAAaaafiAfiSfififififififififiaAfififiAAafii HISTORY: VIEW UPDATE DELETE ESC Delete selected item 66MASTER PERMITAfifififiAAAafifiafififiAAAAAAAfiAfifififiSaAfififififififiAafifiaAfifiAfifiAAAAAAAAfiaafifiAC :MST90-0106: PROJECT:LANGTREE STA']'US:F UPD:12/19/90: :GFS: ° PERMITTEE:TTTAN PROPERTIES PRIM. . :MST9U-C106: SITE ADDRESS:8372 SW LANGTR'— ST ° Oa. CASE HISTORY AAAAAAfififiAAfififififiAAfiaArAi- t ;lSpnt, Schr:/DueAEnd/'DonefiAByfiStata"AC A722 Plumb Top Out 09/04/90 TLP PASS ° A722 Plumb Top Out 09/26/90 MS PASS ° A725 Framing Insp / / MMLmw_A_ee_A_ " ,�� INSPECTION M[�,LC: City cf fi.gerd Building Department 13125 BO Hall Blvd. Tigard, Oregon 97223 Inspection Line (Res..-o_Phone): 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. Underslab Mech. P.)uyh-1.i Appr/Sdw1k Found. Plbq. Top Out Gas Line FINALr PoetjBeam Ntruct. San. Sewer Framing Bldg-� Post;'Beam Mech. Rain Drain Insulation Plumb. P1bq. 'Inderfloor. Nater Line GyF. Bd. Dat ., jested: ,' rJ-- ----_---Times -----AM PH 7 r Addreso=ks 7 .. .c- -Lia —.�----- Permit .-- Builders 6T THE FOLLONIfTO CORRECTIONS ARE REQUIRED: Inspectnr: __- 1)ata2 APPROVED nIRAPPROVED APPROVED SUBJECT TTo ABOVE Call For Reinep. �+s ■w w w w w w w L"KcrION NOTICE City of Tigard B•aildlog Departaent 13125 SW Ball Blvd. Tigard, Oregon 97223 Innlw,ction Lin. (Rec-O-Phone): 639-41'75 Susinene Phone. 39-4171 t..on: ------- - -- u. Plbg. Underslab Mach. Rough-in Appr/Sdwl.k Found. Pl.bg. Top Out Gas Line FINAL: Pont./Beam Struct. Sar.. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation Plbg. Underfloor Nater Line Gyp. Bd. -Mach. Date Recp:edtedt. _—._Times _AM PM Addraee: Permit it,_(*;/j aL Hullder:_ THE FOLLOWING CORRECTIONS ARE REQUIRED: U)006f�k-'a75lfc�'/� ,d�sch�2c% -- Innpectnr:.-� _- -_ Drttes _/Z ?6 - 'kPPROVFD DISAPPROVED APPROVED SUi.TBCT TO ABOVE Call For Reinep. m sar war w, sir rs1 PEW Pw INsgl��+har�c>e ' City of Tigard Fbii.l.diog Del-rt—nt 13125 811 Hall Blvd. Tlga-d, Oregon 97223 'napection Line (Rec-O-Phone): 639-/ 175 Susinees Phone: 634-4171 Inspectiono_—�.- -- -- ---- _-.----- �,pr wlk looting /Sdplbg. Underalab Ne h. Rough-!n .�_Y plbg. Top Out Gas Line FINALS Found. poet./Ream Struct. San. Sewer Framing -nldq. Poet/Ream Mach. Rain Drain tnsulati.on -Plumb. plbg. Underf).00r Water Line Gyp. fid. -Mach. Date Roqueatnd: ----� �zi3.1 Perml� , Address -- Builder: — --THE FOLLOWING CORRECTIONS ARE REQUIRED: — inspectorde APPROVED DISAPPROVED APPROVED 11UBJECT TO ABOVE Call For f ainsp. w s� sss► sssi .. rss .A ssssi 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 #1!� Owner�.---- - — - -- ��C — --- Lot # Bui!der _--� -� — — ---- -- Thr Hilowing Building Code deficiencies are required to tie corrfctad: I i Presented to _ _ N-'Approved Inspector Disapproved Date ' CALL FOR REINSPECTION L-1 YE! U No �f INSPECTION NOTICE City of Tigard Buildin1l Department P.O. Box 23397 Tigard, Oregon 9722.3 � Phone: 639.4175 Type of Inspection Date Requested 4li -�� Time A.M.__ P.M. A.:�ress Y Permit *!4 f LP Owner _ J ___ Lot #_ BuilderThe following Building Code deficiencies are reauired to be corrected: Presented to __- ______ CP�Approved Inspector __ _-____- n Disapproved Date CALL FOR REINSPECTION ❑ YES 0 NO Y INSPECTION NOTICE City of 'Tigard HuAding Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested. "14 ,F- A.M. P.M. / Address a1 Permit #(�41 Owner Lot # Builder___, ['!i„ _ --�- -The following Building Code deficiencies are required to be corrected: I Presented to --- - --- Approval Inspector Disarm Date CALL FOR REINSPEC770N ❑ YES I-A NO s f I. INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oreqon 97223 Phone: 639-4175 Type of Inspection Date Requested T A.M. P.M. Address Permit Owner Lot # Builder The following Building Code deficiencies are requi,ed to be corrected: pok, K/ -x; C c/ Presented to --Approved Inspector EJ Disapproved A D'Itp CALL FOR REINSPEC,710N M YE! E3 NO INSPECTION NOTICE City of Tigard Building Department ,+- i P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspectionjr — Date Requested "� Time A.M. P.M. / L G!j Address L �� Permit # Owner— A � Lot # BuilderThe following Building Code deficiencies are required to be corrected: ------------ Presented to Approved Inspector Disapproved Date CALL FOR REINSPECTION ❑ YES ❑ NO INSPECTION NOTICE-' }' City of Tigard Building Departme-it P.Q. Box 23397 Tigard, Oregun 97223 Phune: 639-4175 Type of Inspection Dzte Requested,_ _ Timn—__— A.M. P.N. Address "V`J Z -�� ✓ �_—_---. Permit -- Owner_ �t A'V'' _ Lot # Builder . -�`3 ` � - -- - — -- T The following Building Code deficiencies are required to be corrected: r- ece eye- ALU Presented to — _ _— pproved Ir,s,ieetor ❑ Disapproved V r)a,te _ ALL OR EINSPECTION ❑ YES ❑ NO INSPECTION NOTICE j City of TigarJ Building Department P.O. Box 23397 Tigard, Or,.don 97223 Phone: 639-4175 Type of Inspection Date Requested__ _ Time_ A.M. P.M. 77 _ , Address LZ' (_LC t/�� - Perm - - Permit # 1-��: - r, — Owner Lot Builder .Gt.tn Le �1 �7 isL The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector �� proved Date -- CAL FOR REINSPEC770PI YES ❑ NO r sssa +� ssr INSPECTION NOTICE City of Tigard Budding Departm-?nt P O. Box 23397 Tigard, Oregon 97223 i Phone: 639-41775 Type of Inspection Date Requested ` Time �,M. P.M. Address _ _ x � Pei niIt Owner —�-_ _. Lot Builder The following Building Code deficiencies are required to be corrected. i -- r - Presented to __---._. -- _-- [?iApproved Inspector _ _..-_ �. Disapnroved Date CALL. FOR R ,L P TION 0 YES I-A NO w asr av ,.r ner s� INSPECTION NOTICE City of Tigard Building DFpartment P.U. Box 2339/ Tigard, Oregor. 97223 Phone: 6639-4175 Type of Inspection -- Date Requested �_`JG Time A.M. P.M. M Address a 3 C �1 ��_ Permit # �- ��Ul✓— Owner _ `� _ — Lot # — Builder —[ i '?,-- The following Building Code deficiencies are required to be corrected: -------------- AIr i Presented to _ ro Impectar -� el,� -- isapproved Date1 P CTTION 0 YER 0 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested 2-7 z 6 — 9A �yTiim, _*<A.M. _P.M., Address -e37-7- Permit Permit Owner Lot Builder The following Building Code deficiencies are required to be corrected: Presented to _. _ —_ __ _ proved Inspector _ Disapproved Date -- — — ---- .^ �!Y- _ LJF CALL/FOR RFIN,SPF(7lON [ I YES 1 1 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection YP P — (.57 Date Requested__ % G Tim A.M. P.M. Address , ;011 �-�'— Permit Owner_ Lot # Buil Jer The following Building Corte deficiencies are required to be corrected: i i f J Presented to Approved Inspector —__ _____--.____ Disapproved Date --_— CALL FOR REINSPECTION Cl YE£ ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 37223 Phone 639-4175 Type of Inspection '��—=� Date Requested—�_L._42- --f0 Time_ / A.M. _P.M. Address b _ 77 —.-_-_--- Permit Owner —_- Lot # _ Builder The following Building Code deficiem s are required to he corrected: Presented to [� Approved Inspector�// v-_--- -------------- ---� -- [_i Disapproved Date CALL FOR REINSPECTION C ! YES 11 NO C'I TY OF 'T I3ARD F'E'FaE I F'T' OF PAYMENT 1 0_E I PT NO. 0 w52 CHEC( AMOUNT r 2q53.BCS �'' I DAME" r T I TAN PROPERTIES CASH AMOUNT' c 0.QQ �D1)RES%. r PAYMENT 'DATE r 66 29!9(:, SUEDIVISION e ALOHA, OF' 970077— 1-97.72 5W LANGTREE: F''I.1PPOSE OF PAYMENT APIOUNT F'AID G'UC-tf-TT"5E OF PAYMENT AMOUNT PAID F.ii p ING PEF'M P'(STg()_ �'!0.16 z 6 1 .r:t(:, ('l (_lMETI N� PERM �,�.'�i� MEC:HANILAL PE T.9.00 JT. BUILD F'E:R act.67r PLAN CHECK FE 9. 75 ";EWER USA t250.0f) l%F WEiF: INSPECT 7`55.CIO STREET SIJ(:. 0() F.AF'.'F!:.7 GDC 'St",. <,t:r STOPM DRAIN SDC' 5r;1, iii► I I I( 01'Al. AMOUNT PAID 08 i tK 1 i k to } i , SEWER CONNECTION CITYOFTIFARD PERMIT' OFTM7 P-ERMIT 0. . . . . . . . SWR9 --O 0tI5 COMMUNrrY DEVELOPMENT r)EPARTMENT C rilyiOnsom P,RIP1. VIERMIT #. : PIS 190 0:F 13126 SW HWI Blvd. P.O.Box 233W,Tigiud,crew'1 97223, I DATE', ISSUED: 06/28/90 SW LA 'TREE I P(WRCEL.: NG 1.4 DTV 1".3 10 N., (b REK,E ZONING% D L 0 C'K. . . .. . . . . . . . . . . . . . . . . . . . t2*7 .............. UENANT NAM — (V'30 NU. . . - , - - - FIXTURE UNITS. . . ( I OSS OF -'O K.. ., H 1::(J DWELLING UNITS- 91 T'Y VIE Cl F U ,E'. NO. OF BUILDINGS11 INSTALL Yt-*,[:.. LALJ(:;WR III!.-,ERV SURFACE. ni a,r k s c Cl w ri e'r: - ---------- --- - _..r.---. --- — TITAN P'ROP'ERTIES type w)))c)t111i, by (ia-te .1,e C.-J:)t PIC) BOX 68 311i` P'R 11T $ .1.250. 00 INSP $ 00 ALUM OR 97007 I-IAYM $ 1.2 00 J1 1-4 0 6 28/`-.30 Phone #s 64554'77 C,(:)Y1t-('ACtnr4 .........-- (-C11qTR(4cTOR NOT' ON 1;:'It.E ................. s ins. 00 TOTAL R F...':0 U I R E D INSFIECTIONS This Applicant agrees to comply with all the rules and reoul!it:.oiis Sewe-r Irii.riritection ......... of the Unified Sewage Aqency. The Permit expires 129 days frog ................... the date issued. The total amount paid will be forfeited if the ............... Permit eXPIrPS. 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 fro% .__.....,_•,.__.__„__..______.._w..__..._.. the distance given. If not so located, the installer shall purchase ——— a "Tap and Side Beller” Pvrait and the Alency wiU install a 'iteral. .............. _......_..w............_._..-__....__ k.1 F.,(i B Y o .................. ...... Call -f -r j.ns p e c t i a ri --- 639-41'75 CITYAF T'VARD M A GTE F,, V.,E R M I T PERMIT ##. , » » . , » r III ST 9 0---0 10 COMMUNITY DEVELOPMENT 0. Crry 1W PRIM. PERMIT #. z 11ST90-0106 %P OA W4 0 1 ME 13126 SW HMI Blvd. P.O.Box 23397,ngW, so,) r75 T)ATI'z ISSUED� 06/29/90 8,i/i2 bW LANC-i'IRLL 5' ] PARCEL: 2SI12CC--09500 P1)1 V L 13 1(IN. . . . .. LONGTREE ZONING: 0("',K. . . . . . . . . LOT . . . . . .. . . . BUIl DING RE'l SSUE:523 IGA DWELL.TNG UNI TSiI3 BASEMENT. . . . . . . . q@ 3 s C.A.-ASS OF* WORK. :NE:W BEPRMS:3 HATIAG c 9 GARAGE.. . . . .. . . . . . .530 5 s TYVIE' OF' USE.. . . .SF FLOOR REQUIRED Yyfl'l:-' OF CONST. . N F'IRST. . . . :50 6 rif LEF*T. . :82 ft RIGHT. :013 ft OCCUPANCY GRP. :R3 SECOND. . . :98 si f FRONT. n 2 ft REAR. . .-89 ft �':;T C)R 1:E G. . . . . . . ::2 T 1.11. . . . . .0 1,C', 's f REOU I RED— 1AF:.I GHT. . . . . ft TOTAI .......:48 -,-F SMOKE DETECTORS. o2 r:,I...00R LOAD. 40 ps f VALUE'.. '75570 PARKING SP,ACES. . Rertia-6,s n ...... PLUMBIMG S I 14KS. . . . . . . . . . ..2 FLOOR DRAINS. . . . -0 BACKF`I OW FIREVNTRS. . I AVOTORIES. . . . . ..31 WA'T'ER HEATL.RS. . . : I I(.)I'.'/SH0WERS. . . . 1. 1 AIJIIDRY TRAYS. . . .0 CATCH WATER CLOSETS., 0 9F.*-'.WEi', 1-INV (ft) . :00 GREASE 1)1 SHWOSHERS. . . : 10 WATER LINE: (ft) . r 0 (a 0 T IA E-Fe. F 1.XT 1.)R V: 0 C`iARRAGE DISP. . . gO RAIN DRAIN (ft) . : :1.0 WASHING MACH. . . r SF* RAIN DRAINS... MECHANICAL FEES UNIT H TR C,;. . r,0 type 'Amount by Gate -r e c,p t VENTS . . . . . .41 PAYM $ 40. 00 JLH 03/12/90 107776, MAX INPUT P9100 BTU VENT F'ANS. . P01 HURT $ 361. 00 I URN { .1.OOK . . .0 HOODS. .. . . . . :0 BF-'LC; 1; 40. 00 FURN )-100K _ ::0 WOODSTOVES. : BSPC $ 1.8. 05 FI OOR FURN. . . . :: CLU DRYERS. cl STDC 11; 600. 00 POIL/C11P < 3HP-. OTHER UNITS41 GSDC $ i--i5o.00 GAS OUTLETSs3 PARK s 250. 00 Owne-ro MCIRT $ 39. 00 ] :TTAN PROPERTIES MPLC $ 9. 7:5 1.11 1.4 0 X 683;''; M51-IC 4, 1. 95 FIFIRI $ 132. 50 AI 0HA OR 97007 P 5 P C. $ G.63 f41ane #s 6455477 f"Aym $ 250. 00 JLH 06/28/90 r'1f))-)trAc_,tC)-r: (::'AY11 $ 141-8. 98 JIJI 06/29/90 1 1 VON CIROPIERTIES 1:,(-) BOX 68.35 01 )HA OR 97007 (At 6456477 jipq #. . n 30558 $ 1708.88 TOTAL This permit is issued subject to the refulations contained in the REQUIRED INSPECTIONS Tiodrd Municipal Code, State of 1JTP. Specialty Codes and all other Foot/fot.tnd Insp Plumb TOP Out applicable laws. All work will be done in accordance with approved Wtr Proof ing Psm Framing Insp plans. This permit will expire if worI, is not started within 188 Post/Ream Innp Fireplace Insp days of issuance, or if work is suspe ed for ore than 188 days. Crawl Drain Gas Line Insp Plm/Lin(islab Insp Ins- UlAtion Insp 1-11 -r, .1sp ` _M/Underf looy, Gyp paa (I 1'.1 Ft,19 Drain Vsm) t Rain drain Insp lFisi.tPd By. ........... Merl-larlical 111sp Wate'r Line Call fo-r insPeetion 639-41*75 CITYDF T167A RD ldww� PLAN CHECK APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ""'"" PLAN CHECK q 13125 S.W.Hall Blvd..P.O.Bort 23397,Tigard,Oregon 97223,(503)639.1175 PERMIT N M,'� DATE ISSUED )(JOB ( RESS: �a TAX MAP/LOT JAL-/.;Z[r; SUB: 1.O1 0 � _ LAND USE: HON: 70 014NER � SPECIAL NOTES -(,,14- NAME- REISSUE OF: 9b-OOo� v^ ADDRCS£<: _t Q S _ _ LAST REISSUE: FLOOD PLAIN/ - - T- ry _ SENSTIIVE 1-AND: APPROVALS REQUIRED CONTRACTOR PLANNING: NAME: _ ENGINEERING: ADDRESS: _ FIRE DEPT _ OTHER: PHONE: ITEMS REQUIRED BUILDERS BOARD M: EXP DAT1_IST/SUBCONTRACTORS: BUS TAX: _ ARCH/ENGINEER CALCULATIONS: _ NAME : _ TRUSS DETAILS: _ ADDRESS:- _ _ _ OTHER: COMMENTS: SUBCONTRAG 1 ORS: PLUMB: PERMIT M ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. OUE 41 10-432 00 Building Permit Fees _ 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees 39. 10--230 01 State Building 'Tax (5%) _;z 6,3 Building Plumbing 10-433 00 Plans Check Fec? lJ.) Building __A Plumbing _ Mech 1<4iy c/15 30-202 00 Sewer Connection S Z-5 30--444 00 Sewer Inspection � I ' 51-446 00 Street System Dev Charge (3DC) GAO 52--449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drait.age Syst Dev Chrg (SSDC) ��SDsyr'� 10-230 06 Fire TOTAL 5 y42 " S S-j=y� RLC t APP TCAN SIGNATURE Received By: J _�- Dat%t Received: cn/3587P/19P -7— GRADING/ ?ROSIO!N CO '113- , INFOR AIM GENERAL.CON'1 RACI'OR NAME & ADDRESS: CA'iEFILE NO.: !I- _ I'll'RMIT NO.: APPLICANT NAME AND ADDRESS: EX�-AVA"TIONCON'TRA(TOR --I.ITAM PRui%:kTI Eoo NAME& ADDRESS: --� LIlc,) 1a)! OWNER NAME AND ADDRESS: TEIT-PIIONE NUMBERS: -- APPLICAN'(': 1 " ! PROPERTY DESCRIPTION: OWNER ► 1 Sl ET ADD ESS AND C SS STREET/LOC TED GENERALC'ONTRAC-IDA: ti r/' 3 ,;) W ' EXCAVA'FIONCONTRA(`TOR_f4'd^ '-il-120 ` SITZ/JOB: _ -- LEGAL DESC.glVnON: 24 HR/AF'ITR IIOURS EMI,RGE-NCY TA X L(}T NO.: C'O ACI'PERSON,' IT'I.f:,:,TELEPHONE; 114 SECTION: r"NF- ' e Ir SITE SIZE,ACRES: DISTURBFD/WORK AREA,ACRES LOCATION&ADDRESS WHERE SPOILS LEAVING SITE WILL.BE TAKEN SITE:? OFF DRAINS TO.(CIRCLE ONE) IN011;;PERMITS MAY Bfi RIiQl11RLD) (CA'1'CA-BASIN DITCH PIPE CREEK (CIRCLE ONE) PMfATE PROPERTY QPUffi lrr TQOHT OF WAY :RO IONISELAM_ENTATION CONTROL. (ESC) MEASURES MINIMI IM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DIIRIM,CONSTRUCTION: FOLLOWING CONSTRUCTION: SEiDIMENTA FION FACILITIES STABILIZE EXPOSED SURFACE STABF IZED COIN STRI J(-FION ENIRANCF. REMOVE AND RESTORE TEMPORARY ESC 1'1 RIMIiIER RUN01-T.CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL.SILT AND DEBRIS COVER PRA(-FICES ENSURE OPERATION OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OTHER OTHER PLAN FOR EROSION CONTROL PREPARED ANI)SI IBMTITED 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 AR's:REMOVALOF EROSION CONTROL MEASURES,AND APPLICABLE STANDARD NOTES. I I{AVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SEDIMENT ON TILE CONSTRUCTION SITE. OWNER SMITATURE, APPLJ ANATURE • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • O . • • • • • . . • • • • • • • • . • • • • • • • • • OITICIAL USF ONLY. RECEIPT DATE ACCEPTED I•l:E: NUMBER RHCEIVED BY