Permit — ----- ' •
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COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION •
1o1owSw Hall Blvd. Tigard, Oregon 97223°8199 (503) 839-4171 PERMIT
PERMIT # ^ SWR95-0029
639-4171 DATE ISSUED: 01/24/95
PARCEL: 2S114A0—WE032
SITE ADDRESq ~ 08932 SW WAVERLY DR
SUBDIVISION ^ WAVERLY ESTATES ZONING: R-12
BLOCK � ^ LOT ^032
________ _ __— •_ _____
TENANT NAME •
USA NO ^ FIXTURE UNITS...
CLASS OF WORK. ..:NEW DWELLING UNI TS. .:1
TYPE OF USE 'SF NO. OF BUILDINGS:1
INSTALL TYPE ^BUSWR IMPERV SURFACE..: :sf
Remarks: PATH I
Owner: — — --- — FEES ---- -----
GREG LEWELLING type amount by date recpt
15867 SW 81ST CT • PRMT $ 2200.00 JF 01/24/95 -
. INSP $ 35.00 JF 01/24/95 —
TIGARD OR 97224
Phone #: 684-7568
.Contractor: .
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Re #
Reg ..
REQUIRED INSPECTIONS
This Applicant agrees to cooply 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 froo
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Peroit and the Agency will install a lateral.
__ __ _
Permitt ,Si gnat ur� ` :
I ssued By:
� Call for inspection — 639-4175 .
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5/24/00 Activities for Case #: SWR95 -00009 .
2:05:30 PM
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Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received .
BLT 1/10/95
SWRA010 Plan check by - 1/10/95 BLT 1/10/95
SWRA020 Check for prcl. restrict. 1/10/95 v 1/10/95. JLG PASS BLT 1/10/95
SWRA705 Sewer Inspection BLT 1/10/95 •
SWRA080 (F) Issue permit 2/8/95 JF JF 2/8/95
SWRA720 Case Finaled 3/9/95 MS PASS MRS 3/9/95
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