Permit I -"
• i r•s t, - r - T a.
PERMIT
,CITY OF TIGARD PERMIT 06/20/966 -0255
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 1 S 125DA -1 1400
SITE ADDRESS...: 06500 SW TAYLORS FERRY RD
SUBDIVISION....: 1996 -005 ZONING: R -4.5 .
BLOCK........... LOT.............:
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: PATH I
Owner: FEES —
NDC LTD. type amount by date recpt
P 0 BOX 1985 PRMT $ 2200.00 J -H 06/20/96 96- 280800
INSP $ 35.00 J*H 06/20/96 96- 280800
LAKE OSWEGO OR 9
Phone #: 697 -3801
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 located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
_____4441.6L
Permittee Signature: ,'Ii A
I .det
IIII Call for inspection — 639 -4175
Page No. 1 CASE HISTORY FOR CASE NO.: SWR96 -0255
NDC LTD.
06500 SW TAYLORS FERRY RD
12/02/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
SWRA010 Plan check by / / / / 05/21/96 05/29/96 BT2
SWRA020 Check for prcl. restrict. 05/21/96 / / 05/24/96 PASS BON 05/29/96 BT2
SWRA070 Ready to issue / / / / 05/30/96 PASS CJS 05/30/96 CJS
SWRA080 (F) Issue permit / / / / 06/20/96 PAID JMH 06/20/96 J *H
SWRA080 (F) Issue permit / / / / 06/20/96 PAID JMH 06/20/96 J *H
SWRA705 Sewer Inspection / / / / / / 05/29/96 BT2
SWRA720 Case Finaled / / / / 08/06/96 PASS MS 08/06/96 MRS
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