Permit CITY OFTIGARD
2 , 1 ,,, ,; \
DEVELOPMENT 9
SEWER CONNECTION PERMIT #PERMIT SWR98 -0266
• DATE ISSUED: 10/06/98
I PARCEL: 2S1O2CB -01805
SITE ADDRESS...:1O4O0 SW PARK ST
SUBDIVISION • ZONING: R -3.5
BLOCK LOT • JURISDICTION: TIG
TENANT NAME °CHILDREN'S VILLAGE
USA NO • FIXTURE UNITS...: 132
CLASS OF WORK...:NEW DWELLING UNITS..: 8 '
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •LTPSWR IMPERV SURFACE: 0 sf
Remarks: RE: PLM98 -0358
Owner: FEES
JUMBO FERNANDO type amount by date recpt
17549 SW MEADOWS LN PRMT $ 18400.00 DLH 10/06/98 98- 309740
LAKE OSWEGO OR 97034 INSP $ 45.00 DLH 10/06/98 98- 309740
Phone #:
Contractor:
OWNER
Phone #: $ 18445.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
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- m1-0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
/ /
Issued by: Permittee Signature: /
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + ++
•
Accumulative Sewer Tally ��
nant Name: UPI_ t 2FN S VItz-4GE This SWR#
dress: /OYO Scd` ./ Mw PAAJJA;11 PLM #: °Pb 6
Lure Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off #s count value values
ptistry/Font 4
th - Tub /Shower 4
r
- Jacuzziiwhirlpool 4
it Wash - Each Stall 6 •
- Drive Through 16
ispidor/Water Aspirator 1
. shwasher - Commercial 4 'v,/ 4 ( 4
- Domestic 2
inking Fountain 1 — 2 L 2 Z
re Wash 1
oor Drain /sink - 2 inch 2 _ / 1 Z _
-3inch 5 ',' / t '7
- 4 inch 6
- Car Wash Dm 6
arbage Disposal 16 � / I I I te
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
e Machine /Refrigerator Drains 1
il Sep (Gas Station) 6 .
ec. Vehicle Dump Station 16 • •
_
•
hower - Gang (Per Head) 1 ..
•
- Stall 2 _ ✓/ 2- l Z
ink - Bar/Lavatory 2 '-'-g I L I (0 •
- Bradley 5
- Commercial 3 1/0 -1 20 10 3
- Service 3
swimming Pool. Filter 1 i 1 / I
Vasher - Clothes 6 ✓ / G ( 0
Vater Extractor 6
Vater Closet - Toilet 6 v e LI ' •
Jrinal 6
/ I3Z 35 152- TOTALS
rotal fixture values: I 3 divided by 16 = $ .2-C EDU - 1)0 'S
•
-IISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
i :'dstslswrtaty.doc
•
8/8/99 Activities for Case #: SWR98 -00266
3:20:06 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRC003 Application received 9/28/98 BON RECD DLH 9/28/98
SWRC008 Permit Created 9/28/98 DLH DONE DLH 9/28/98
SWRCO25 USA Sewer Card Processed 9/28/98 DLH DONE DLH 9/28/98
SWRC705 Sewer Inspection 10/2/98 1018198 TLP PASS TLP 10/8/98
SWRCO32 DST Post - Review Completed 10/2/98 B DONE BON 10/2/98
SWRC070 Ready to issue 10/2/98 B PASS BON 10/2/98
SWRC080 (F) Issue permit 10/6/98 DLH DONE • DLH 10/6/98
SWRC720 Case Finaled 1/14/99 JT 1/14/99
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