Permit CITY OF T SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PERM I l
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERM I T # • SWR95- 0033
639 -4171 DATE ISSUED: 02/03/95
PARCEL: 29104BD —RM004
SITE ADDRESS... : 13790 SW ROSY CT
SUBDIVISION • ROSE MEADOWS ZONING: R -7
BLOCK • LOT • 004
TENANT NAME •
USN NO..........: FIXTURE UNITS...:
CLASS OF WORK... : NEW DWELLING UNITS.. :1
TYPE. OF USE • SF NO. OF BUILDINGS : 1
INSTALL TYPE •BUSWR IMPERV SURFACE..: :s
Remarks: PATH I
Owner: —• FEES
JAY MILLER type amount by date recpt
P U BOX c30459 PRMT $ 2200.00 JF 02/03/95 —
INSP $ 35.00 JF 02/03/95 —
TIGARD OR 97281
1-:'none #: 684 -7543
Contract or:
CONTRACTOR NOT ON FILE
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 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 A ency will install a lateral.
Permittee Signature,
Issued By: _ 4all for inspection — 639 -4175
5/24/00 Activities for Case #: SWR95 -00033
•
•
2:15:23 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received BLT 1/23/95
SWRA010 Plan check by 1/23/95 BLT 1/23/95
SWRA020 Check for prcl. restrict. 1/23/95 1/23/95 RT PASS BLT 1/23/95
SWRA705 Sewer Inspection BLT 1/23/95
SWRA080 (F) Issue permit 2/3/95 JF JF 2/3/95
SWRA720 Case Finaled 2/24/95 , MS PASS MRS 2/24/95
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