11405 SW WALNUT STREET 'r
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ADDRESS:
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ALOHA SANITARY SERVICE
P.O. BOX 309, BANKS, OREGON! 97106
644-2797 / 648-6254 / 324-4343 1619-5188
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ADCRESS
PHONE- -------�-- --- HOME - ` - WO
JOB SITE- -' � � �U S '�' _l_L�.►�i..�_._._�'�
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CHARGE PAID f3 Al CHECKEl
t , CASH VISA 0
DATE// DR VE
r(�'' AMOUNT
- -- REMARKS - -
TYPE OF TANK: STEEL / CONCRETE 1 PLASTIC 1 O'rHER
HORIZONTAL I VERTICAL / RECTANGLE I OTHER
SIZE OF TANK: 350 1 500 I 750 I 1000 1 -1250 1 1500 f
LID LOCATION: INLET 1 OUTLET I MIDDLE 1 GrHER
CONDITION O`- TANK: GOOD 1 FAIrl 1 POOR
FITTINGS: BAFFELS I CONCRETE I CAST IRON / PLASTIC
NEEDS NEW LID U SIZE
GROUND COVE:f, JVER TANK _ ______
COMMENT ON CONDITION OF DRAINFIELD ETC.
RECE7VBY _j
TOTAL
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INSPEC-1ON NOTICE /NL
'ity of Tigard Building Departnent,
13125 SW 9r1L Blvd. Tigard, Oregon 97223
Iuapection tine (Rec-O-Phone): 639-4175 Business Phone: 639-4171.
1 Inepection:� _Footing Plbg.Plbg. Underelab Mach. hough-in Appr/Sdwlk
Pound. Plhg. Top Out Gas Line FINAL:
Poet/Beam Struct. Snn. Seaer� Fraying -Bldg.
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Post/Beam Mech. Rain Drain Tieulation -Plumb.
Plbg. Underfloor Nater Line cyp, bd. -Heck.
Da`a Reaueeteda
Address: ��G� fel/��>�u� _ Permit #:e,
Builder:
THE ?OLLOWING CORRE ONS ARE REQUIRED:
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Inspector: / /y, .3 _- -_ Date.
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
�O�--APCall For Reinap.
C�.TY OF TICARD
COMMUNITY DEVELOPMENT DEPARTMENT MYanooN
COXYMID SEWER CONNECTION
13126 SW HWI Blvd. P.C.Box 23397,TlgaM,Orepn 97 223(603)6394176
'PRMTT 4-
61s9-4171 nATE ISSUED: 06/02/9-'-`
-�if'E ADDRESS. . . : 11405 SW WALNUT ST PARCEL: 2SIOZAb-
SUBDIVISION— . . : PAPTITTOH PLnT 1r3";10-33 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : t
TENANT NAME. . . . . :
USS NO. . . . . . . . . : F I XTLARF UNIT,. . . -
CLASS OF WORK. . . rADD DWELL I NG UN 17 F3. . - I
TYPE OF USF. . . . . :SF NO. OF BUILDINCS: 1
INSTALL. TYPE. . . , -BUGWR TIMPERV SURFACE. . :
Pemar,ks : Connec.,t existing SFD to sewer, �Spptic tani, to be p!imrned and -filled with
s,_:md or- yr-avel.
DwTler-: FEES
KENT WISER type amol.mt by date r,e c:p
1140b SW WALNUT ST PIRMT $ 19010. 00 JLH 06/02/9-2
-
IN'.P $ 3ts- 0 14) JLH
TIGARD OR 97i=_',:_:'3
Ptione #:
Lontraa,tov
C & S PLUMPING
i592 SE 5is'r
H I L LSK/R0 OR 97123
Plhor)e #.- 503' -640-577121 1 1935. Ofel TOTAL
19907
REQUIRED INSPEC71ONS
This Applicant agrees to cosply with all the rules and mulatim Set-get- Ins'pection
of the Unified Sevage Agency, The permit expir:-. _'tl days frog
the date issued. The total avount paid will be forfeited if the
pernit expires The Agency does not guarantee the accuracy of the
side sewer lateralc, if the sewer 4s not located at the Peasurement
giver, the installer shall prospect 3 feet in all directions frov
the distance given. If not so located, the installer shall -irchase
a "Tan and Side Eewer` Persit and the Agency will install a lateral.
pt.31-mittee
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I I for-, inspection 639-4175
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CITY 1' 1�_� � 131u sw tjau Blvd. PLNCK/REGI #O (TARD
1'0[lox 21397 PERMIT # 2.7
COMM(IN IIY 1)E'VELJP LENT DEPARTMENT Tigard,0,cgon97223 —
(503)639-4171 DATE ISSUED
JOB ADDRESS: //tir;5' ,i,=r TAX MAP/LOT 3.1'vv' Z
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SUB: LOT: LAND USE: _
VAI UAT I ON:
OWNER SPECIAL NOTE
NAME: — =� Z- �y .E —__ REISSUE OF: `
ADDRESS: ice s' ��r �s « <�/��,Vtl r _ LAST REISSUE:
FLOOD PLAIN/
PHONE: _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUUIRED
NAME_: PLANNING:
ADDRESS: ENGINEERING:
—_ _ ------ --- FIRE DEPT: _—
PRONE: --__ .—. _ _ OTHER: _ _--
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB _N_— _ LIST/SUBCONTRACTORS:
i,iECH: — BUS TAX:
ARCH ENGINEER CALCULATIONS: _
NAME: _ _v TRUSS DETAILS:
ADDRESS: OTHER: --- — -- --
a PHONE: .- -- — --- --- -- _ - -
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PROPOSED BLDG. USE: �_--
COMMLNTS:
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APPLICANT SIGNATURE Received By: -- --_--_-__._ Date Received: --.- ---- _—_-_---
P�RMII # ASCI # DESCRIPTION AMOUNT AMOUNT P0. BAL. DUE
10- 932 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building _
Plumbing
Mechanical
10-433 00 Plans Check Fee --
Building _
Plumbing
Mechanical
10-230 06 Fire
30-2.02 00 Sewer Connection
30-444 00 Sewer Inspection '
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
2.5-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Miss Transit TIF Fees
52-449 00 Parks System Dev Charge (POC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445--01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
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TOTAL ---- -- -- --- -
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nm/3587P.W111
June 1, 1992
City of Tigard
13125 S.W. Hall Blvd.
P.O. Box ?.3397
Tigard, OR 97223
Attention: Brad Rccast
Dear Mr. Roast.
We gave Fo(it D Construct Lon Company a sewer easement across
the westerly edge of ou- property in the fall of 1991. Until
that time our neighbor. Wallace Sweeney, had no access to the
sanitary sewer.
It is our understanding that Mr. Sweeney wants to hook 1
the sewer and was recently wuiexed t- the city. Pleas( ,ue
him the necessary -ernit.
Yours truly,
Brenda Wiser
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