Permit CITY OF TIGARD
,d, DEVELOPMENT SERVICES SEWER CONNECTION
('$1 � PERMIT
= 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 PERMIT # • SWR98 -0069
DATE ISSUED: �- - 0
PARCEL: 1 S 135CD— 9500 ' N
SITE ADDRESS...:09923 SW PIHAS CT
SUBDIVISION °JACOB COURT ZONING: R -12
BLOCK LOT •003 JURISDICTION: TIG
TENANT NAME °CHAD E. DAVIS
USA NO • FIXTURE UNITS...: 0
CLASS OF WORK... :NEW DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks:
New SF — Path 1
Owner: FEES
CHAD E DAVIS type amount by date recpt
PO BOX 794 A•INSP $ 35.00 GEO 04/22/98 98- 305173
FOREST GROVE OR 97116 PRMT $ 2200.00 DRA 05/05/98 98- 305497
Phone #:
Contractor:
OWNER
Phone #: $ 2235. 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- rai through OAR 952- 0001 -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
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++
•
7/25/99 Activities for Case #: SWR98 -00069
6:26:41 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 4/9/98 JD RECD BON 4/14/98
SWRA008 Permit Created 4/14/98 B DONE BON 4/14/98
SWRA705 Sewer Inspection 4/14/98 5/15/98 RB PASS RB 5/15/98
SWRA080 (F) Issue permit 4/22/98 GEO PASS GEO 4/22/98
SWRA085 (F) Reprint Permit 6/9/98 GEO DONE GEO 6/9/98
SWRA720 Case Finaled 11/23/98 JT 11/23/98
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