Permit CITY OF T 4EWER CONNECT ION
DEVELOPMENT SERVICES PERMIT
PERMIT # • SWR96 -0454
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: i 0 / 17 / 96
PARCEL: 2S104DD -01800
SITE ADDRESS...: 12939 SW RIDGEFIELD LN
SUBDIVISION • MOUNTAIN HIGHLANDS #2 ZONING: R -4.5 PD
BLOCK, LOT •015
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 1
Owner: FEES
BEAR CONSTRUCTION CO type amount by date recpt
8076 SW 184TH AVE PRMT $ 2200.00 B 10/17/96 96- 285298
INSP $ 35.00 B 10/17/96 96- 285298
BEAVERTON OR 97007
Phone #: 642 -3512
Contractor: — -- --
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #.
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, e installer shall purchase
a °Tap and Side Sewer° Permit and th- 'g , cy will install a lateral.
Permittee Signature:
Issued By: vti.J
Call for inspection — 639 -4175
2/14/00 Activities for Case #: . SWR96 -00454
4:35:52 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By ' Updated Notes
SWRA007 Application received BT2 9/23/96
SWRA010 Plan check by 9/6/96 BT2 9/23/96
SWRA020 Check for prcl. restrict. 9/6/96 9/12/96 JH PASS BT2 9/23/96
SWRA705 Sewer Inspection 11/5/96 MS PASS S`W 8/13/97
SWRA070 Ready to issue 9/30/96 CJS PASS CJS 9/30/96
SWRA080 (F) Issue permit 10/17/96 B PASS . BON 10/17/96
SWRA080 (F) Issue permit 10/17/96 JT 11/6/96
SWRA720 Case Finaled 11/5/96 MS PASS S'W 8/13/97
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