Permit CITY OFTIGARD
• o Hy,,y , DEVELOPMENT SERVICES SEWER CONNECTION
h134 PERMIT
7 ' �. . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • SW R97 -0 147
DATE ISSUED: 06/04/97
PARCEL: 2S104DB —AH024
SITE ADDRESS... :13147 SW ROCKINGHAM DR
SUBDIVISION •AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT •24 JURISDICTION: TIG
TENANT NAME •CLOSE HOMES
USA NO FIXTURE UNITS...: 0
CLASS OF WORK... :NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 0
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Path 1
Owner: FEES
GREG SIMMONS type amount by date recpt
4214 SW KANAN DR PRMT $ 2200.00 DRA 06/04/97 97- 295433
PORTLAND OR 97221 INSP $ 35.00 DRA 06/04/97 97- 295433
Phone #:
Contractor:
OWNER
Phone #: $ 2235.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
of the Unified Sewage Agency. The per.it expires 188 days from
the date issued. The total amount paid will be forfeited if the
per.it 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 .teral.
Permittee - '• ature: 1 , • ' t
Issued By . C.., I r,u .
Call for inspection — 639 -4175
•
1/21/00 Activities for Case #: SWR97 -00147
4:51:30 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received 5/6/97 B PASS BON 5/8/97
SWRA705 Sewer Inspection 5/28/98 GS PASS GES 5/28/98 passed by review of ( ground
work insp by Bob Bandelow
8 -21 -97 ) and review of contr
invoice, see file
SWRA070 Ready to issue 6/2/97 JSD PASS JD 6/2/97
• SWRA080 (F) Issue permit 6/4/97 DRA PASS DRA 6/4/97
SWRA720 Case Finaled 5/28/98 PASS GES 5/28/98
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