Permit •
•
• CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
1 J.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 PERMIT
PERMIT # SWR97 -0367
DATE ISSUED: 09/30/97
PARCEL: 2S104DD -02100
SITE ADDRESS...:12862 SW RIDGEFIELD LN
SUBDIVISION •MOUNTAIN HIGHLANDS #2 ZONING: R -4.5 PD
BLOCK LOT •018 JURISDICTION:
TENANT NAME •LUTTRELL ENT INC / TANNER
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: New SFD
Owner: FEES
LUTTRELL ENT INC / TANNER type amount by date recpt
224 NW SUNDOWN WAY PRMT $ 2200.00 JSD 09/30/97 97- 299634
PORTLAND OR 97229 INSP $ 35.00 JSD 09/30/97 97- 299634
Phone #:
Contract or:
LUTTRELL ENTERPRISES INC
224 NW SUNDOWN WAY
PORTLAND OR 97229
Phone #: 297 -5231 $ 2235. TOTAL
Reg #..: 000994
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
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 - 801-8010 through OAR 952-63814380. You as .btain copies of
these rules or direct questions to OUNC by ca ing (503)246 -1987.
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Lc/7 L- 0i47 i jY r -- Issued by: I�� ` � Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + +++ + + ++ + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ ++ + ++ + + + + + + + + + + + + + + + + ++ + + + + + + ++
5 /17 /99 Activities for Case #: SWR97 -00367
9:10:47 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 9/22/97 9/16/97 GEO PASS JD 9/22/97
SWRA008 Permit Created 9/22/97 9/22/97 JSD PASS JD 9/22/97
SWRA705 Sewer Inspection 9/22/97 11/3/97 GS PASS J'H 11/10/97
SWRA032 DST Post - Review Completed 9/29/97. B DONE BON 9/29/97
SWRA070 Ready to issue 9/29/97 • B PASS BON 9/29/97
SWRA080 (F) Issue permit 9/30/97 JSD PASS JD 9/30/97
SWRA720 Case Finaled • 11/3/97 GS PASS J`-1 11/10/97
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