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HomeMy WebLinkAboutBLD2007-00499 !UILDING PERMIT APPLICAN MLA07-00532 Review Type:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD07-00499 Received Date: 9/13/2007 SITE ADDRESS: 282084 HWY 101 PORT TOWNSEND, 98368 OWNER: ELLYN SPENCER PHONE: 978-500-0703 67 BRICKETT HILL CIR HAVERHILL MA 018301580 SUBDIVISION: Block: Lot: PARCEL NUMBER: 902231003 Section: 23 Township: 29 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: JOHN & MELANIE DICKSON PHONE: 360-301-1297 915 TAYLOR STREET PORT TOWNSEND WA 360-301-12 PROJECT DESCRIPTION NEW SFR W/ATTACHED GAR &A/G 120 GAL PROPANE TANK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 960 VALUATION 11,0;16,68 ADD'L: 290 HEAT TYPE: PRO CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R 3 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N GOARAGE:THER: 770 SHORELINE: CONST TYPE: DECK: 192 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 Routing Date: g1 i 3 F 0 l (1.--)er Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,055.35 CJZ 09/12/07 93218 \PPRVEIJ Plan Check $685.98 CJZ 09/12/07 93218 State Building Code $4.50 CJZ 09/12/07 93218 OCT 18 2007 Potable Water Application $58.00 CJZ 09/12/07 93218 Total: $1,803.83 Jefferson County Planning &Building Department • Jefferson County Building D!•ion Permit Nun.: BLD07-00499-- Applicant: SPENCER BUILDING PERMIT INSPECTION APPROVALS \pplicable Code: 2006 International Building Codes To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection. Requests received after 7:00 AM will not be scheduled for that day's inspections. ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries. The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection Inspection Item Date Approval Signature Notes Setbacks Erosion Control Foundation FootingFFee= /,u5-A4LC-07) t 6/66,Fk Footing Drains `r roc,e �''�'`''3' 'mart V` Foundation Stem Wall .1:24by Underground Plumbing c ,.,uLLY Straps(hold downs) Ext. Shear Wall Nailing - Rough-in Plumbing Lfi c k Framing � `I(cft s-. Blocking Airseal G/4,/OS Wiu s 4 Doecs O k 6/if/08-X Insulation:Walls 6////GB Insulation: Floors `///0$ ram Uu U vEk FL . oK 5/7-/A8 Insulation: Ceiling G 6 PI!/� 1/1 Int. Shear Wall Nailing G/fir/pg" 64 058 G/i/TAI Wallboard Nailing , Gas Line: Interior wJ Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage Address Posted ( r •:" FINAL INSPECTION I (91 U — lyt ao rN\ -ro a I; ►2 eyoT L•k'N k—c9c-l(ct..p TA• FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# :BLD07-00499 1.) PRIOR TO SCHEDULING A FINAL BUILDING INSPECTION A KNOX BOX SHALL BE INSTALLED ON THE GATE FOR ACCESS TO THE PROPERTY IN CASE OF EMERGENCY. If you have questions regarding this requirement please contact Fire Chief Wilson at 360-774-0674. 2.) The application was reviewed by the Jefferson County Department of Community Development staff on October 8, 2007 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: Shoreline Slope Stability- Intermediate, Landslide Hazard Area - Slight, Susceptible Aquifer Recharge Area (SUSC), Seawater Intrusion Protection Zone (SIPZ) - High Risk & Coastal. 3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 4.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 5.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3) All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit (4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit(5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 6.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 7.) Among the native conifer species which may be used in buffers or for re-vegetation include, but are not limited to: Grand Fir(Aibes grandis), Sitka Spruce (Picea sitchensis), Shore Pine (Pinus contorta), Douglas Fir (Pseudotsuga menziesii), Western Red Cedar (Thuja plicata), and Western Hemlock (Tsuga heterophylla). Among native tree species which may be used includes: Vine Maple (Acer circinatum), Big-Leaf Maple (Acer macrophyllum), Red Alder(Alnus rubra), Pacific Madrone (Arbutus menziesii), Quaking Aspen (Populus tremula), Black Cottonwood (Populus trichocarpa), Bitter Cherry (Prunus emarginata), Oregon White Oak (Quercus garryana), Cascara (Rhamnus purshiana), Pacific Willow (Salix lasiandra), and Scouler's Willow (Salix scouleriana). Among the native shrub species which may be used are: Sevice-Berry (Amalanchier alnifolia), Red Osier Dogwood (Cornus stolonifera) Salal (Gaultheria shallon), Ocean Spray (Holodiscus discolor), Indian Plum (Oemlaria cerasiformis), Pacific Ninebark (Physocarpus capitus), Red Flowering Currant (Ribes sanguineum), Wild Rose (Rosa nutkana), Swamp Rose (Rosa pisocarpa), Willows (Salix ssp.), Red Elderberry (Sambucus racemosa), Snowberry (Symphoricarpos albus), Evergreen Huckleberry (Vaccinium ovatum), Red Huckleberry (Vaccinium parvifolium). 8.) Marine ntrus on shorelines and islandsintrusions a� a water ii . i a conditionsceptible in whichtoa the condition saltwater/freshwaterthatisknown s interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 9.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 10.) The parcel is located within a High Risk SIPZ (seawater intrusion protection zone) according to the County GIS map. There are mandatory measures identified in the Jefferson County Seawater Intrusion Policy (Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A High Risk SIPZ is defined as: areas within 1,000 feet of a groundwater source with a history of chloride analyses above 200 milligrams per liter(mg/L). 11.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 12.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 13.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 14.) All construction activities shall not encroach upon the landslide hazard buffer. This includes the storage or preparation of materials. 15.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 16.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 17.) VOLUNTARY MEASURES OF C.TAL SIPZ: 4111 Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 18.) VOLUNTARY MEASURES OF COASTAL SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 19.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 20.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 21.) The applicant is proposing to create or add 1,761 square feet of impervious surface and 5,800 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology Stormwater Management Manual for Western Washington to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 22.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 23.) The site plan as submitted with the building permit application on September 12, 2007 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated October 8, 2007 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 24.) This approval is for a single-family residence with attached garage only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 25.) The parcel has been designated as Rural Residential 1:5 under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 26.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 27.) Not more than 2 unlicensed vehilOshall be stored on any lot unless totally sillned from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an autormobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 28.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 29.) Setback from private access easement right-of-way is no less than 20 ft., setback from Hwy. 101 right-of-way is no less than 50 ft., side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 30.) JCC 18.35.250 Building and occupancy permits—Issuance after final short plat approval. (1) No building permit for a structure other than a temporary contractor's office or temporary storage building shall be issued for a lot or parcel within an approved short subdivision prior to a determination by the relevant fire district chief or designee that adequate fire protection and access for construction needs exists. (2) No building permit for a structure other than a temporary contractor's office or temporary storage building shall be issued for a lot or parcel within an approved short subdivision until the applicant complies with the improvement method report, all requirements of the department of public works certificate of improvements, and all requirements of the final plat approval. (3) No occupancy permit for a structure other than a temporary contractor's office or other approved temporary building shall be issued for a structure on a lot or parcel within an approved subdivision prior to final inspection and approval of all required improvements which will serve such lot or parcel to the satisfaction of the director of the department of public works and county building official. 31.) The well location was reviewed as a part of the Dickson Short Plat SUB06-00045 and was determined to be outside of the High Risk Seawater Intrusion Protection Zone. The project is required to meet the requirements for Coastal Seawater Intrusion Protection Zone. 32.) Fire Chief Bob Wilson commented on the project as follows, "It appears that the road system to Mr. Dickson property is suitable for our emergency vehicles. The one request I have is a Knox Box be installed on the gate for access to the property. Please make this a condition of the permit if possible." 33.) On October 10, 2007 the Jefferson County Public Works Department commented as follows, "He has complied with the PWD's requirements. We wouldn't object to issuing a building permit." III • ... oypARTMENT OF CCMM.UNrrYpEVi!LOPMENT ,, , • 6z1 si ridan Street• Port Townsend•Win ti reil l a. 3SO/3�9-4450 360/379 4451 Fax SEF �'cY www.eo.jeffersortwa.usfeomrr eleprnent a a,. Master Permit Application MLA: 0 l '33a- .Project.Dosctt (include stporate s eeits as�necessary): , J ti Q et t e r. (rrf r L h�l q•• .� Cox Parcel t;� 2,...2�T1 Q g ( Prapett�r Number. r' __ Size: t.O. m k1'` T (zcredtsquare feat)- . Ste Address prim/or oirecttnne to�Propody . ii Property owns (s of Rico - T84aphone; ?,0 ftax -email: .' Mailing Address: Apfiiicantf.6eTil tg (ft ortferonk fr#yi.ewnort: Ira h r4 D i k is i At ti 2►G' t Q i xr ;40" .. Teitsphone:. tQ-:Q/-12 517 Fox: ' J 'Arnett: • Imitirz,4&fdn es: `•7 ` .. �• �rL° 'F torsi- "3,� ie ..,, .,, . Wttet kind•af Pefsttit?(Check etfc box that amines. - l1Qaulldin9 tj Variance(Minor,•Major orRaasp4Wta Economic tree) l` O t ie nolittori Perrnit ©Conditional Uso(G(o),C(d},or C]"'" r t 'Singie Family C3 Garage Attached I Detached 0 i)isorafonary"D"or Unnamed Use Cfassffication 0 Menufac turdd t-tcme 0 Mortutar LI Spacial Usa(ESsentiai Public:-acitid®f)." o Cor:irr:erclat" 4 foundry Rine AdjuOtroarit O Change of Use Cl abort Pit*" in Addrea+a Cl Rood Approach - 0 f3fnding Site Plan" t3Home Businssa 0 Cottagerrxluotiy ©t.bng Ptat'" 'Propane 0 P4,c►ner3 Rural Resider►tlat D¢veloprnent(PfileilAthendmetitr" O Sign 0 Plait Vst nWAlteratien"• M't Atlwvtsti'Yes"t:tso Conalafenpy Anatyele El t3horcline Master Pt'Cxgrom E mption/Permit Revision$*" • d Stomwator Managatnertt .0 Shoreline Menage♦nent'Substantlai Dev*•topmenf" ratite Pten Approval Advance 13efoinninelion(SPAAb)* ❑tft1orefne Man:tgernai'rtVa►iance . 0 Temporary iJ e Cr Comprehenatve PlentilDCll_2nr1 Uue Distr#-Map lkatsprrnr$nt fa Morels Telecommunication* 0 Jof arson County Shoreline Master Program Amnndfnent 0 Forest f rocttoes Ant/Release of 81x Yeor Moratorium Cl Tree vegeta&on Requeel 'Magrrt r!ea Oftt tetpptfraisen Civrl*kf es . . "Raquimt aPie-App►rration Cantdrnce Ptaalse Idetttify any other local,state or federal prat'mft.a tsequired for this proposer,If known: _ OE NATIC$(d.C r AegNT _ • I hereby designate r9 0 I.f."-t)--C;iPa1 to gat as my agent in matters relating to th mppli ' afar perralt(s). If ny►ignERinvU ttNA TUlEk catbn the�o rmefr/ t sete that the!tn[fo Gfm�aS Pat pSn`w� he' rein rein,andin any tldt t: o . Kin,lc true andL eo rtJe et to the beat of hit,her or It's krroludge_ Any material fakohood Of any anioslonaaf s aarttettat fad made by the ownartegent With ro>tpect to tMs appllrnben poaket- May result In Ink permit being nos and vat. t tertian agfct 1,4 save,indemnifyr situ fsotd haantetts,teaftersanfiottniy seeing'all liabilities,itAt rtianie,'soon costs.reasonable attain s feae and expenses which may in any*ay nova eigairmt Jefferson County et a result of or hi consequence of the maxi of Ms penal I rufttter ewe In plearde amass and right of wary to JJffereon.0ettny And tie empfoyo63,mpri entativec of merge for the eats purpoceof eppll66116e . review and airy required titer Inspecilonsr. staffs Access and date of entry MI be aeaumed unless the-appfkma.Mfortgsthe*ninny trrwiiting et the than of the apl!f tie or Mu wants pro*matte. Sipnotorte �. r• DKr �~ S �� The action er sctions Applicant win rinrterteke ea a result of the Ise/ones of this pant may negatively irwack,ttport one•ormete thrantannd of • • erittaNnittakt apostles end noun)toad to a pairmtfai`taker eaten endanperad spedies 6S those forme t►ro defined in the federal-taw known at the 'Endeftfrered Species Are^or VIM.'Jefferson County makes no assurances to the epplrcard.that 4t w edloof.that wlate undeitaken basemen try worm!has bean isaund%ON riot violate the ESA, my fndlviduat farncp•oragane;,r can fits ii WI uit On behalf of an endangered spodkts regarding your +ae ion(3) Ettan ityou ate le emplane*with the Jeffentan.County dbvelefiment node.The Applicant eekiaewledgcs.that no,ahe*Armies rmies indttttlual And nota=ikensfera rn ponsibwty for e4herkeg to and complying With the C9A. The Applicant flab read this dtmor�ndvirus Ana daet ft ;tow. ; rurrure Data: / ieSt. 7 •Gt\Fermitc•At r1#ronpiti4t5# \DRp rows 5\Miitgc r'oin+s plieation t2-t9;30Ar dac . ' BUILDER STATEMENT The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming he responsibility of the General Contractor for the proposed project. �_-� �n Date;. 9 — i 2 77 Signature �--� GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: CO ilfm✓►/0fel G n i Nn - _ Lc. • ( co3) 3 Lc-- .3 ( co ) 'I/ 23'-7 MAILING ADDRESS: +q 3 MG'-iY7 S pr;u 0l 01703 EMAIL: -..`( rtct.t 4W." ' C CONTRACTOR'S LICENSE /(� [� I // WAINS NUMBER: tJI(s ` 13L i 9-12/\ 2 NUMBER , ARCHITECT/ENGINEER: Niv,i, 01O1.G5o1,1 PHONE (8 3) )i 51., z5/ FAX:•( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: $ New • 'K Wood Existing: 0 Sewer , ❑ Addition 0 Steel Proposed: 2 Bank 0 Community System O Alteration/Remodel 0 Concrete Total: Z . Height: % Individual System O Repair 0. Masonry_ SEP Permit# 07"-?F0 O Demolition 0 Other: Bedrooms: Water Supply: Existing: Setback: • p Private well y Two.Party 'r~ Type � of Heat: Proposed: Z.- - .0 Public 9' All',`rev} ,1 a,19 e%p4Y .. Total, . 7—. Name of System:Al 136 If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: I Underground Tank XAbove ground Tank Size of Propane Tank: 1 Z 0 cgai/ Meat Stove )(Cook Stove`' I Woodstove I Fireplace Insert I Hot Water Tank I Pellet St6ve I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying fora permit to install a propane,tank:you`must8ilso submit a site plan showing all of the buildings,all property lines, tank location and'3ize,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area: 'J , $ouare Foota-e Current .. Pro osed "or'0461 9:1 i Oflf.. .:: .,. . `,U;`);lf)r R(1°,i9Se�r) ._.• "- ......,..: Main Floor Heated t- _ EH_BldApp Review: EV - (og 2ftl Floor Heated(A,,,vn o,v9 Consistency Review: . 1 5 Other Heated` Base fee: I ,ocS 3 Mezzanine • Additional Section: t Heated Basement Plan Check fee: lOa °' Unheated Basement ; ' .'p,y;Y State Surcharge fee: . Other Unheated _ 2.5 0 , e a So ''ot Water Review fee: Garage/Carport "7 7o . :,. , A t;.. SUBTOTAL .yQ� Decks • ' 911/Rd Approach fee:, /q`Z Other ' TOTAL: $ , .4 t-3- l R=- el t Number: g ;< ; ash/Check Number ut. 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