Form B70-1036 REV 2/14
(TO BE SUBMITTED WITH BUILDING PERMIT APPLICATION)
I WILL CONSTRUCT AND MAINTAIN EROSION CONTROL MEASURES AS PER THE ATTACHED PLAN OR
MODIFY AS NECESSARY TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE.
GENERAL CONTRACTOR:
COMPANY NAME: _________________________________
ADDRESS: _______________________________________
_________________________________________________
PHONE: _________________________ EXT: ________
CONTACT: _______________________________________
JOB SITE PHONE: _________________________________
24-HR EMERGENCY PHONE: ________________________
SITE INFORMATION:
SUBDIVISION: ____________________________________
________________________________________________
LOT NO.: ______ ADDRESS: _______________________
________________________________________________
LOT AREA: ___________________________________SQ.FT.
DISTURBED AREA: ____________________________SQ.FT.
MULTIFAMILY/COMMERCIAL:
EXISTING IMPERVIOUS AREA: __________________ SQ.FT.
NEW IMPERVIOUS SURFACE AREA: _____________SQ.FT.
EXCAVATION CONTRACTOR:
NAME: __________________________________________
PHONE: _________________________________________
LOCATION WHERE SOILS LEAVING SITE WILL BE TAKEN:
______________________________________________________
______________________________________________________
OWNER:
NAME: __________________________________________
ADDRESS: _______________________________________
_________________________________________________
PHONE: _________________________________________
SITE RUN-OFF DRAINS DIRECTLY TO:
**CHECK ALL THAT APPLY**
___ PRIVATE PROPERTY ___ PUBLIC ROW
___ CATCH BASIN ___ DITCH
___ PIPE ___ CREEK
___ OTHER: ____________________________________
ATTACHED IS A PLAN FOR EROSION CONTROL THAT
HAS BEEN PREPARED IN ACCORDANCE WITH THE
TECHNICAL GUIDANCE HANDBOOK. INCLUDED ON
THIS PLAN ARE COMPLETE CONSTRUCTION NOTES,
SITE ELEVATION CONTOURS, AND APPLICABLE
STANDARD DRAWINGS.
SIGNATURE: ___________________________________________ TITLE: ______________________________
PRINTED NAME: _______________________________________ PHONE: _____________ EXT: ________
DATE OF APPLICATION: _________________________________
CITY OF BEAVERTON
Community Development Department
Building Division
4755 SW Griffith Drive /PO Box4755
Beaverton, OR 97076
General Information-(503) 526-2222 V/TDD
www.BeavertonOregon.gov
EROSION CONTROL GENERAL INFORMATION
12725 SW Millikan Way / PO Box 4755
Beaverton, OR 97076
Phone: (503) 526-2493 Fax: (503) 526-2550
General Information (503) 526-2222 V/TDD
BeavertonOregon.gov
