Permit SEWER CONNECTION
. CITY OF TIGARD PERMIT
PERMIT # • SWR96 -0344
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/23/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 291 04DD -01900
SITE ADDRESS...: 12860 SW R I DGEF I ELD LN
SUBDIVISION • MOUNTAIN HIGHLANDS #2 ZONING: R -4.5
BLOCK • LOT • X116
TENANT NAME •
USA NO • FIXTURE UNITS...: 0
CLASS OF WORD.... : NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: PATH I
Owner: FEES
ANDREW REAM type amount by date recpt
9895 SW HIALEAH PL PRMT $ 2200.00 JSD 07/23/96 96- 281770
INSP $ 35.00 JSD 0 207/23/96 96- 281770
BEAVERTON OR 97005
Phone 4: 524 -8058
Contract or : --
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #.. .
REQU I RED 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.
Perm ittee Signature: _ _ �_— __ _
I s sued 0 y : — -- - -- ---- - — -- - - - - — -- - — — - --
Call for inspection - 639 -4175
5/23/00 Activities for Case #: SWR96 -00344
2:40:36 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA01 Plan check by 6/28/96 BT2 7/10/96
SWRA020 Check for prcl. restrict. 6/28/96 7/5/96 JD PASS BT2. 7/10/96
SWRA705 Sewer Inspection 7/1/97 RAB PASS J'H 7/7/97
SWRA070 Ready to issue 7/11/96 CJS PASS CJS 7/11/96
SWRA080 (F) Issue permit - 7/23/96 JSD PASS JD 7/23/96
SWRA720 Case Finaled 7/1/97 RAB PASS J'H 7/7/97
•
•
Page 1 of 1