Permit CITY TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR1999 -00224
;,�y� DEVELOPMENT SERVICES DATE ISSUED: 10/22/1999
'' = 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171
SITE ADDRESS; 09012 SW PIPPEN LN PARCEL: 2S111 DA -15600
SUBDIVISION:. APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 149 JURISDICTION:
TENANT NAME: LEGEND HOMES,
USA NO: FIXTURE UNITS: 0
CLASS OF WORK: NEW DWELLING UNITS: • 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new single family. dwelling.
Owner: FEES
LEGEND HOMES
6900 SW HAINES Type By Date Amount Receipt
TIGARD, OR 97223 • PRMT BON 10/22/1995 $2,300.00 99- 319284
INSP BON 10/22/1995 $35.00 99- 319284
Phone: 620 -8080 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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Sewer Inspection
ORIGINAL
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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 co ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
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Issued by: / ' I Permittee Signature:
• Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next • : ness day
3/7/00 Activities for Case #: SWR1999 -00224
8:35:06 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level ' By Updated Notes
SWRA003 Application received 10/13/99 DEB RECD No Hold GEO 10/18/99
SWRA008 Permit Created 10/18/99 GEO DONE No Hold GEO 10/18/99
SWRA705 Sewer Inspection 11/1/99 MS PASS No Hold MRS 11/1/99
SWRA070 Ready to issue 10/19/99 BON DONE No Hold BON 10/19/99
SWRA080 (F) Issue permit 10/22/99 BON DONE No Hold BON 10/22/99
SWRA720 Case Finaled 2/21/00 AKJ DONE No Hold AKJ 2/21/00
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