Permit CITY OF T SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT # ° SWR95- 0130
13125 SW Hall Blvd. Tigard, Oregon 97223.B99(Q)1639141l1 DATE ISSUED: 03/31/95
PARCEL: 15133CC -01500 •
SITE ADDRESS...: 14065 SW SPRINGBROOK LN
SUBDIVISION ° PEBBLECREEK ZONING: R -25
BLOCK LOT -009
TENANT NAME
USA NO FIXTURE UNITS...:
CLASS OF WORK...: NEW DWELLING UNITS..: 1
TYPE OF USE .SF NO. OF BUILDINGS :1
INSTALL TYPE °BUSWR IMPERV SURFACE..: :sf
Remarks: PATH I
Owner: — —• FEES - - - - - --
COSTA PACIFIC HOMES type amount by date. recpt
8625 SW CASCADE BLVD PRMT $ 2200.00 JDA 03/31/95 --
INSP $ 35.00 JDA 03/31/95 --
BEAVERTON OR 97005
Phone #: 503 -646 -8888
Contractor: — — ------
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 ocated, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will instal, a lateral.
Permittee Signature: 1PL.,-
901,
Issued By:
Call for inspection — 639 -4175
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3/9/00 Activities for Case #: SWR95 -00130
1:06:49 PM
Assigned Hold . Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 APPlication received BLT 3/29/95
SWRA010 Plan check by 3/29/95 BLT 3/29/95
. SWRA020 Check for prc. restrict. 3/29/95 3/22/95 SW PASS • BLT 3/29/95
SWRA705 Sewer Inspection _ BLT 3/29/95
SWRA080 (F) Issue permit 3/31/95 JDA - JDA 3/31/95
SWRA720 Case Finaled 4/7/95 MS PASS GES 4/7/95
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