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13155 SW Grant Avenue
_ ENGINEERING PERMIT
ITTof � IGARD PERMIT#: ENG2001-00041
DEVELOPMENT SERVICES PRIM. PERMIT#: MLP2001-00003
13125 SW Hall Blvd.,Tigai-1, OR 97223 (503) 639-4171 DATE ISSUED: 8/28/01
SITE ADDRESS: 13155 SW GRANT AVE PARCEL: 2S102CB-01300
SUBDIVISION: POOLE MLP200'-00003 ZONING: R-4.5
BLOCK: LOT: Ur)l JURISDICTION: TIG
PERMIT TYPE: SOP _PUBLIC INiP R\' QUANTITY LIN FT VALUE
AGREEN ENT DATE: GRA/ERGS: '"'
ASSURANCE EXPIRATION _ STREET:
-" - SAN SEW:
PERFORMANCE: STM £EW:
MAIN(17KIANCE: PATHWAYS: "
ALL OTHER: """ $1,100.00
TOTAL: $1,100.1 10
Remarks: STREET OPENING, TO INSTALL A SIDE SANITARY SEWER SERVICE LATERAL, A DOMESTIC WATER
SERVICE, RAIN DRAIN AND UTILITY SERVICES.
FEES
Owner:
Type by )Date Amount Receipt
OPEN CTR 6/18/0 i $150.00 272001000C
Total $150.00
Phone:
Engineer:
REQUIRED INSPECTIONS
Phone: -- —
STM/SAN SEWER STREE't
_ _
Permittee 1 Applicart: MH/661C0 — CRB LINE & GRADE
POOLE CONSTRUCTION PIPE. LN & GRD SUBGRADE
145 Nr- 13TH BCKFLt & CMPCT BASE ROCK
C-AMB,', ':.R 97013 AIR &TV TEST LEVEL COURSE
WEARING COURSE
'RAFF & PED CUNT
Phone: 503-522-9545 _GRADING I!IONUMENTATION
CONTOURS STRFETLIGHTING
DRAINAGE WALK/APRONIRAMP
PeiTnitteel EROSION CNTL.
Applicant X
Signature.: oC _ - PATHWAYS
REPR'SIADJ'S_ _ —._.—.
Issued ByFOR INSPECTIONS, CONTACT THE CITY OF TIGARD,
SPECIAL CONDITIONS: (SEE ATTACHED) ENGINEERING, 01:PARTMENT, AT: (503) 639-4171
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