Permit CITY OF TIGARD EWER CONN ECTION
1- �;� DEVELOPMENT SERVICES
PERMIT # HERMI T 5WR97- 0064
1.L. 13125 DATE ISSUED: 04 /25/97
PARCEL: 25104DB —AH044
SITE ADDRESS...:13130 SW ROCKINGHAM DR
SUBDIVISION •AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT •44 JURISDICTION: TIG
TENANT NAME •
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: Single family new residence
Owner: FEES
DALTON CONSTRUCTION INC type amount by date recpt
8465 —A SW HEMLOCK ST PRMT $ 2200.00 B 04/25/97 97- 293758
TIGARD OR 97223 INSP $ 35.00 B 04/25/97 97- 293758
Phone #:
Contract or:
OWNER
Phone #: $ 2235.00 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 l' 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 'eill install a later -1.
mi
Permittee Si ature: ■ i
Issued By:
Call for inspection — 639 -4175
Page No. 1 CASE HISTORY FOR CASE NO.: SWR97 -0064
DALTON CONSTRUCTION INC
13130 SW ROCKINGHAM DR
06/17/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
- --- --- -- -- -- -- ---
SWRA007 Application received / / / / 03/04/97 RECD JSD 03/05/97 PHN
SWRA070 Ready to issue / / / / 04/24/97 PASS B 04/24/97 BON
SWRA080 (F) Issue permit / / / / 04/25/97 PASS B S 04/25/97 DST
SWRA705 Sewer Inspection / / / / 05/08/97 PASS MS 10/01/97 MRS
•
SWRA720 Case Finaled / / / / 05/08/97 PASS MSZ 10/01/97 MRS