Permit CITY TIGARD SEWER CONNECTION PERMIT
"u'�a ta. DEVELOPMENT SERVICES PERMIT #: SWR2000 -00189
rl i a 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/6/00
SITE ADDRESS; 12541 SW QUAIL CREEK LN PARCEL: 2S104DA -00200
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 039 JURISDICTION: TIG
TENANT NAME:
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: S/F PATH I
Owner: FEES
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 SW GALEWOOD ST
STE 100 PRMT CTR 9/6/00 0,300.00 27200000000
LAKE OSWEGO, OR 97035 INSP CTR 9/6/00 $35.00 27200000000
Phone: 503 - 387 -7538 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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: // ' • i Permittee Signature:, 0
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
9/12/00 Activities for Case #: SWR2000 -00189 ,
11:25:31 AM
'
Assigned • Hold Updated
Activity Description Date 1 Date 2 Date 3 . ,„
To Done By Disp. Level By Updated Notes
SWRA007 Application received 7/11/00 DEB DONE No Hold BT2 7/22/00
SWRA008 Permit Created 7/22/00 BT2 DONE No Hold BT2 7/22/00
SWRA705 Sewer Inspection No Hold BT2 7/22/00
SWRA070 Ready to issue 8/24/00 GWL DONE No Hold GWL 8/24/00
SWRA080 (F) Issue permit 9/6/00 DLH DONE No Hold BLD 9/6/00
SWRA085 (F) Reprint Permit 9/11/00 ZZZ DONE No Hold ZZZ 9/11/00
SWRA720 Case Finaled 9/11/00 MRS DONE No Hold MRS 9/11/00
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