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Permit O F T I GARD — CI1Y PERMIT # PERMIT SWR93-0476 COMMUNITY DEVELOPMENT DEJ*RTiVIBNT DATE ISSUED: 11/05/93 -13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 28104BB -06300 SITE ADDRESS...: 14127 SW STARDUST LN SUBDIVISION • CASTLE HILL ZONING: BLOCK • LOT -004 TENANT NAME • USA NO..........: FIXTURE UNITS...: CLASS OF WORK...:NEW DWELLING UNITS..:1 TYPE OF USE •SF NO. OF BUILDINGS:1 INSTALL TYPE •BUSWR IMPERV SURFACE..: :sf Remarks: PATH I Owner: FEES WICKENS CONST INC type amount by date recpt 18317 SW FALLATIN LOOP PRMT $ 2200.00 JH 11/05/93 — INSP $ 35.00 JH 11/05/93 — ALOHA OR 97007 Phone #: 591 -1833 Contractor: 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 purchase a °Tap and Side Sewer' Permit and the Agency will instal lateral. Permittee Signature: r-- DJ.OA 1 ns - W i'Ll Issued By: Call for inspection — 639 -4175 .f7 1 45 - 77 7 3/9/00 Activities for Case #: SWR93 -00476 • 1:02:38 PM Assigned Hold Updated • Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SWRA007 Application received • BLT 10/26/93 SWRA010 Plan check by 10/26/93 BLT 10/26/93 SWRA020 Check for prd. restrict. 10/26/93 10/26/93 VG BLT 10/26/93 • SWRA705 Sewer Inspection BLT 10/26/93 SWRA080 (F) Issue permit 11/5/93 JLH PASS JH 11/5/93 SWRA720 Case Finaled • 11/29/93 MS PASS MRS 11/29/93 • • • • • • Page 1 of 1 •