Permit �t.wEK GuwmLL/Ium
PERMIT
CITY � TIGARD
PERMIT #.......: SWR96-0256
DATE ISSUED: 06/20/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223°8199 (503) 639-4171 PARCEL: 16125DA-1 1500
SITE ADDRESS...: 06508 SW TAYLORS FERRY RD
SUBDIVISION....: 1996-005 ZONING: R-4.5
BLOCK..........: LOT.............
_________ _
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 ----
NDC LTD. type amount by date recpt
P 0 BOX 1985 PRMT $ 2200.00 JMH 06/20/96 96-280801
INSP $ 35.00 JMH 06/20/96 96-280801
LAKE OSWEGO OR 97035
Phone #: 697-3801
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 the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a latiral.
__ __
Permittee Signature: »8
— -- ---
Issued By ,4�
4110 Call for inspection — 639-4175
•
Page No. 1 CASE HISTORY FOR CASE NO.. SWR96 -0256
NDC LTD.
06508 SW TAYLORS FERRY RD
12/02/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
SWRA010 Plan check by / / / / 05/21/96 05/29/96 BT2
SWRA020 Check for prcl. restrict. 05/21/96 / / 05/24/96 PASS BON 05/29/96 BT2
SWRA070 Ready to issue / / / / 05/30/96 PASS CJS 05/30/96 CJS
SWRA080 (F) Issue permit / / / / 06/20/96 PAID JMH 06/20/96 J *H
SWRA080 (F) Issue permit / / / / 06/20/96 PAID JMH 06/20/96 J *H
SWRA705 Sewer Inspection / / / / / / 05/29/96 BT2
SWRA720 Case Finaled / / / / 08/06/96 PASS MS 08/06/96 MRS