Permit • CITY OF TIGARD / ;' SEWER CONNECTION PERMIT
y ,�, , r �'� DEVELOPMENT SERVICE QQ I PERMIT #: SWR1999 -00093
Al '��� 13125 SW Hall Blvd., Tigard, OR 97223 (5 03). 8 �- G I A TE ISSUED: 7/19/99
SITE ADDRESS; 14207 SW 116TH TERR PARCEL: 2S110BA -08900
SUBDIVISION: EVERGREEN SPRINGS ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: TIG
TENANT NAME: RENAISSANCE CUSTOM HOMES
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: New SF - Path 1
Owner: FEES
RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt
1672 SW WILLAMETTE FALLS DR
WEST LINN, OR 97062 PRMT DST 7/19/99 $2,300.00 99- 316964
INSP DST 7/19/99 $35.00 99- 316964
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
•
This Applicant agrees to comply with all the rules and regulations 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 from the distance given. If not so located, the installer shall purchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain co . s of rules or • irect questions to OUNC by calling (503) 246 -1987.
Issued by: � Permittee Signature: . - , _ .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
4/26/00 Activities for Case #: SWR1999 -00093
2:22:08 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 4/23/99 BON RECD No Hold BON 4/27/99
SWRA008 Permit Created 4/27/99 BON DONE No Hold BON 4/27/99
SWRA705 Sewer Inspection 8/30/99 GS PASS No Hold AKJ 8/30/99
SWRA032 DST Post - Review Completed 5/7/99 DRA DONE No Hold DRA 5/7/99
SWRA070 Ready to issue 5/7/99 DRA DONE No Hold DRA 5/7/99
SWRA080 (F) Issue permit 7/19/99 GEO PASS No Hold DST 7/19/99
SWRA720 Case Finaled 8/30/99 AKJ DONE No Hold AKJ 8/30/99
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