Permit CITY TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR1999 -00214
u5�1� DEVELOPMENT H B Tigard, ) 639 -4171 DATE ISSUED: 11/03/1999
SITE ADDRESS; 09811 SW PIHAS CT PARCEL: 1S135CD -09300
SUBDIVISION: JACOB COURT ZONING: R -12
BLOCK: LOT: 001 • JURISDICTION: TIG
TENANT NAME: KIMCO PROPERTIES LTD
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: • 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for a new single family dwelling.
Owner: FEES
KIMCO PROPERTIES LTD Type By Date Amount Receipt
22060 SE 442ND AVE •
SANDY, OR 97055 PRMT BON 11/03/199c $2,300.00 99- 319525
INSP BON 11/03/199£ $35.00 99- 319525
Phone: 503 - 668 -7075 Total $2,335.00
Contractor:
Phone:
• Reg #:
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Required Inspections
Sewer Inspection
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.
, I/ /
Issued by: — � ' j(,( /I�� � Permittee Signature: ,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the ne busine - day
6/5/00 Activities for Case #: SWR1999 -00214
1:24:16 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 9/23/99 GEO RECD No Hold GEO 9/29/99
SWRA008 Permit Created 9/29/99 GEO DONE No Hold GEO 9/29/99
SWRA020 Check for prcl. restrict. 9/29/99 9/29/99 GEO No Hold GEO 9/29/99 MLP99 -00001 not recorded at
time of submittal.
SWRA705 Sewer Inspection 12/7/99 MRS PASS No Hold MRS 12/7/99 underfloor plumbing on wrong
side of house
SWRA032 DST Post - Review Completed 10/7/99 GEO DONE No Hold GEO 10/7/99 Engineering gave ok to issue on
10/1/99.
SWRA070 Ready to issue 10/7/99 GEO DONE No Hold GEO 10/7/99
SWRA080 (F) Issue permit 11/3/99 BON DONE No Hold BON 11/3/99
SWRA720 Case Finaled 4/4/00 AKJ DONE No Hold AKJ 4/4/00
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