Permit '7+
' CITY OF TIGARD
| DEVELOPMENT SERVICES SEWER CONNECTION
/ �~m~� =~m~�~. .�"~~v� n ~~�~"x�"~�m~�� PERMIT
| ,��� ^11. 13125 SN/MaKflm1 Tigard, ����7/
Blvd., �°-- ' ~/ PERMIT #. . . . . , : SWR97-T079
DATE ISSUED: 03/28/97
PARCEL: 2S1035G-H86931
EI ADDRE5S...:126 9 5U 115TH gVE
�.
G�DDIVISION,...:HU^JTcR'S GLEN ZONING: R-4.5 PD
BLOCK.......... LOT...".........:031 JURISDICTION:
__ _______________________________________ _ _______________
TENANT NAME.....:
USA NQ..........: 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
' '^s: PATH 1
Owner: -------------------- - FE�S -------'------
LEDGE HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 2200.00 JSD 03/28/97 97-292340
TIGARD OR 97223 lNSP $ 35.00 JSD 03/28/97 97-29234q
Prune � :
Contract orF: --- -- -----------
CWNE9
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Phone #: . $ 2235.00 TOTAL
9eg �+. . :
------- REQUIRED INSPECTIONS -
This Applicant ap"opo to cump7y with all the rules and rea:lations Sewer Inspect ion ... ___ _
of the UniFied Sewace Aueocy. The peruit expires 180 days fnor __
the date issued. The total ocnoot paid will be forfeited if the _~____ ______ ___ . ______
peroit expires. The Acency does rot guarantse the accuracy :f the ________ __ _________
siee sewer laterals. If the sewer is not 'coated at the neasmpoed _____________________ ____ ___ __
givor, the installer shall prospect 3 +eot in all directions fro _____ __________ __._________
the distance oiven. If not so ocated the installer shall purchase ____.________________ _______________.
a Tap and Side " t and the Ay ________
Pprmittcp -- /^/r Rq - --- ' __-________�___
- c �— ------------- -------------------- '
___ _ ___ _
___ ____
Issued By -__-_-'____ -_-_________---_—
i-, .
Call for inspection - 639-4175
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5/30/00 Activities for Case #: SWR97 -00079
1:59:40 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received 3/20/97 BON PASS BT2 3/25/97
SWRA010 Plan check by 3/25/97 BT2 3/25/97
SWRA705 Sewer Inspection 4/4/97 MS PASS MRS 4/7/97
SWRA070 Ready to issue 3/26/97 JDA PASS JDA 3/26/97
SWRA080 (F) Issue permit 3/28/97 JSD PASS JD 3/28/97
SWRA720 Case Finaled 8/4/97 JT 8/4/97
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