Permit CITY OF T SEWER CONNECTION
• ��,�, „; ,;, DEVELOPMENT SERVICES PERMIT
' I 'I PERMIT # SWR96 -0472
'� �.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
DATE ISSUED: 11/26/96
PARCEL: 2S104DD- 02800
SITE ADDRESS...: 12835 SW RIDGEFIELD LN
SUBDIVISION - MOUNTAIN HIGHLANDS #2 ZONING: R -4.5 PD
BLOCK LOT •025
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
BETTER BUILT HOMES type amount by date recpt
PO BOX 5672 PRMT $ 2200.00 JSD 11/26/96 96- 286982
INSP $ 35.00 JSD 11/26/96 96- 286982
BEAVERTON OR 97996
Phone #: 648 -5401
Contract or:
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 188 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 •urchase
a "Tap and Side Sewer” Permit and the Agenc- wil nstall/ late' -1.
Permittee Signatur- ° �� APPIP"-IA
�� %/
Issued •
C all for inspection — 639 -4175
5/23/00 Activities for Case #: SWR96 -00472
3:07:13 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received BT2 10/15/96
SWRA010 Plan check by 10/9/96 BT2 10/15/96
SWRA020 Check for prcl. restrict. 10/15/96 10/15/96 JA PASS BT2 10/15/96
SWRA705 Sewer Inspection 2/11/97 MS PASS MRS 2/12/97 sewer to be pumped
SWRA080 (F) Issue permit 11/26/96 JSD PASS JD 11/26/96
SWRA705 Sewer Inspection 7/9/97 RAB PASS J'H 8/12/97 Changed tap, sewer incomplete
SWRA705 Sewer Inspection 7/11/97 RAB PASS J *H 8/15/97 new tap converting from
pressure to gravity approved
SWRA720 Case Finaled 8/18/97 JT 8/18/97
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