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Permit SEWER CONNECTION CITY OF TIGARD PERMIT PERMIT # • SWR96 -0376 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08 / 21 / 96 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 251 10DB -00200 SITE ADDRESS...: 15284 SW ROYALTY PKWY #C SUBDIVISION • WILLOWBROOK FARM /ARBOR HEIGHTS ZONING: R -25 BLOCK LOT •8 TENANT NAME •BUILDING C USA NO FIXTURE UNITS...: 0 CLASS OF WORK...:NEW DWELLING UNITS..: 20 TYPE OF USE •MF NO. OF BUILDINGS: 1 INSTALL TYPE •LTPSWR IMPERV SURFACE: 0 sf Remarks: BLDG C, 1 OF 14 MF UNITS Owner: FEES SECURITY CAPITAL PACIFIC TRUST type amount by date recpt SUITE 201 PRMT $ 44000.00 JMH 08/21/96 96- 283125 330 112TH AVE., NE BELLEVUE WA 98004 Phone #: 206- 451 -9292 Contractor: DONALD M DRAKE CO 1740 NW FLANDERS ST PORTLAND OR 97209 Phone #: 620 -0868 $ 44000.00 TOTAL Reg #. °: 084045 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 Agency will install a lateral. Permittee Signature: Issued By: Call for inspection — 639 -4175 • Page No. 1 CASE HISTORY FOR CASE NO.: SWR96 -0376 SECURITY CAPITAL PACIFIC TRUST 15284 SW ROYALTY PKWY Unit: C 07/20/98 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By • SWRA010 Plan check by / / / / 08/05/96 08/05/96 J *H SWRA070 Ready to issue / / / / 08/06/96 APPR JMH 08/06/96 J *H 'SWRA080 (F) Issue permit / / / / 08/21/96 PAID JMH 08/21/96 J *H SWRA705 Sewer Inspection / / / / 04/11/97 PAS TLP 04/11/97 TLP SWRA720 Case Finaled / / / / 04/11/97 PAAS TLP 04/11/97 TLP • •