Permit CITY TIGARD SEWER CONNECTION PERMIT
• 4 DEVELOPMENT SERVICES . PERMIT #: SWR2000 -00024
'-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 02/14/2000
SITE ADDRESS; 10055 SW INEZ ST PARCEL: 2S111 BC 00500
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -3.5
BLOCK: LOT: 019 JURISDICTION: TIG
TENANT NAME: MARSHALL, JAMES & ANNETTE
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection receipt # 00- 321688. Reimbursement District #13 fee paid. ($8,000.00) receipt
#00- 321687 Septic tank must be pumped filled and inspected.
Owner:
FEES
MARSHALL, JAMES H + ANNETTE L
10055 SW INEZ ST ,Type By Date Amount Receipt
TIGARD, OR 97223 PRMT KJP 02/14/200C $2,300.00 00- 321688
INSP KJP 02/14/200C • $35.00 00- 321688
Phone: . Total $2,335.00
•
Contractor:
Phone: •
Reg #:
Required Inspections
Sewer Inspection
Septic Tank Filled
ORIGINAL
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 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 installer shall purchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: Permittee Si
Y � nature
9
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
3/8/00 Activities for Case #: SWR2000 -00024
12:47:19 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 2/14/00 KJP RECD No Hold BON 2/14/00
SWRA008 Permit Created 2/14/00 BON DONE No Hold BON 2/14/00
SWRA705 Sewer Inspection 2/16/00 MRS PASS No Hold MRS 2/16/00 emergency sewe installation
• ok to backfill
SWRA710 Septic Tank Filled 2/17/00 MS PASS No Hold JMT 2/22/00 septic pumped & filled.
received pump receipt.
SWRA080 (F) Issue permit 2/14/00 KJP DONE No Hold KJP 2/14/00
SWRA720 Case Finaled 2/22/00 JMT DONE No Hold JMT 2/22/00
•
Page 1 of 1