Permit 5 .WtK LUNNL 11UN
PERMIT
CITY OF T PER M I ISSUED: 04i2 -0181
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 2S1 1 1 AA —GPO49
S I T L 1 i z5'd .Tigard, Pg$g "7 81 1 3) W1 71
SUBDIVISION....: GREENSWARD PARK NO. 2 ZONING: R -4.5
BLOCK........... LOT...... ....... :049
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 —• --
ROSEWOOD HOMES INC type amount by date recpt
7140 SW 209TH PRMT $ 2200.00 CJS 04/25/96 96- 278599
INSP $ 35.00 CJS 04/25/96 96- 278599
BEAVERTON OR 97007
Phone #: 642 -4049
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 N Pct 7:---- �—
_
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 in all a lateral.
Permittee Signature: �/„����� /�
Issued By . fi�.�'W
/ .' I — - .
0 Call for inspection — 639 -4175
•
6/16/00 Activities for Case #: SWR96 -00181
1:38:29 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received BT2 4/22/96
SWRA010 Plan check by 4/4/96 BT2 4/22/96
SWRA020 Check for prcl. restrict. 4/4/96 4/9/96 JH PASS BT2 4/22/96
SWRA705 Sewer Inspection BT2 4/22/96
SWRA070 Ready to issue 4/24/96 CJS PASS CJS 4/24/96
SWRA080 (F) Issue permit 4/25/96 CJS PASS CJS 4/25/96
SWRA720 Case Finaled 6/20/96 MS PASS MRS 6/20/96
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