9060 SW MCDONALD STREET 132HIS GIVNOQOW MS 0906
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9060 SW MCDONALD ST
SEWER CONNECTION
CITY OF TIGARD � PERMIT
PERMIT #. . . . . . . : 5WR96--0413
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09/04/96
13126 8W Hall Blvd.Tigard,Orogon 97223.6190 (603)639-4171
PARCEL: 2S111A8-00300
IiL ADDRESS. . . : 09060 SW MC DONALD ST
SUBDIVISION. . . . ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
TENANT NAME. . . . . :WALSH, MICHAEL/KATHY (OWNERS)
USA NO. . . . . . . . . . . FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :ADD DWELLING UNITS. . : 1
TYPE „r L'%. . . . . :SF NO. OF BUILDINGS: 1
I N5TAI_L T`/PE. . . . :BUSWR I MPERV SURFACE: 0 s f
Remarks - CONNECI TO SEWER FROM MC DONALD REIMBURSEMENT DISTRICT, STUBBED
OUT TO LOT - SEPTIC TANK TO BE DUMPED, FILLED, CAPPED & INSPrD.
Owner: ---------------------------------- --- FEES
MICHAEL WALSH type amount by date recpt
09060 SW MC DONALDAp MISC f 3405. OL JMH 08/26/96 96•-283288
V �PRMT $ 2200. 00 JMH 08/26/96 96-2:83`81.3
T I GARD OR 9722:3 I NSP f 35. 00 JMH 08/26/96 96--2E3288
Phone #:
ontractor: ----_------------+--
OWNER V
Phone #: 5640. 02 TOTAL
Rey #. . : OWNER
------- REOUIRED 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 Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
permit expires. Th! Agency does not guarantee the accuracy of the
side sewor lat*ral5. 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 sa located, the installer shall purcha,e
a "Tap and Side Sewer" permit and the Agency will install a lateral.
I>o r m it tee S i y n at 1_t r fa
Issued By :
CL
Call for inspection - 639-4175
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Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(533) 639-4171
Jobsite Address: (fn 1,4 �
Subdivision: zz ]/,t _ Lot# �' Office Use Only
,� Contact Date / ! Initials
Valuation: Uyu,001 � Result
New Construction Only: (Square Footage) l �. Planck/Rrt� "
Permit #
Nouse: _ Garage: Reissue of
Corner Lot? Y N Fla Lot? Y N Map & TL#
Flag Zone_
dvel—
/ePlat #Owner: f Li✓ALs.� -
Address:
ixn ( ApprovalsPe uQ ired
4'2412�G'�,r/ ^�� Planning Setbacks _ GSolar
`
aL--,.—o. Engineering �✓�d= I�F,
Other
Phone: (� � ) &10 /5 s�
Items Required
Contractor:
Subcontractors _
Address: Truss Details
Other _
L
Phone: ) y Notes
Contractor's License #
(attach copy of current Oregon license)
Contact Name:
Contact Phone:
Subcontractors: Architect/Engineer:
CL Plumbing: Aridress:
H
Mechanical:
H (attach copy , 'current OR Contractor's License)
J Phone:
W JOB DE"CRIPTIO
_j / - /
Applicant Signature Applicant Phone number
Received by: Date Received:
, o.,mise..na
Permit S Account Description Amount Amt. Pd. Bal. Dus
Bldg. Permit (BUILD) ,
Plumb. Permit (PLUMB)
Mech. Permit ' + (MECH)
Stats Tax (TAX)
Bldg:
Plumb: /
Mech:
Plan Check (PLANCK
Bldg:
Plumb:
Mech:
Sewer Connection (S USA
Sewer Inspection ( WINSP)
Parks Dev Charge PKSDC)
Residential TIF (TIF-R)
Mass Transit Tic (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF ' (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
L Water Quality (WQUAL)
C
Water Quand (WQUANT)
Fire Life Safe (FLS)
D
a Erosion Cntrl Permit (ERPRMT)
J (Erosion Planck/USA (ERPLAN) ^�
Erosion Planck]COT (EROSN)
TOTALS:
ALOHA SANITARY* SERVICE
P.O. Box 309, BANKS, OREGON 97106
644-2797 648-6254 639-5188
MAME: /7 1/7C 1.57
ADDRESS: /
CITY: STATE: iQ ZIP:
PHONE: / HOME: / WORK:
Joe SITE: r P.O.#:
PAID BY CHARGE Cl � CHE K m CASH ❑ CREDIT CARD ❑
DATE DRIVER AMOUNT
40
_ PUMP SEPTIC TANK -
❑ MATERIAL - ----
❑ INSPECTION FEE
❑ SERVICE CALL_
❑ LABOR, LOCATING, DIGGING & BACKFILL
t -1 Z�7
-THIS IS NOTA ,:EPTIC SYSTEMINSPECTION REPORT---- TOTAL $
- - REMARKS - -
TYPE OF TANK: STEEL ❑ CONCRETE ❑ PLASTIC ❑ OTHER
HORIZONTAL ❑ VERTICAL❑ REC-ANGLE Cl OTHER _
SIZE OF TANK: 350 ❑ 50007500 1000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: INLET ❑ OUTLET ❑ MIDDLE ❑ OTHER
IL TANK CONDITION: GOOD ❑ FAIR ❑ POUR Cl
FITTINGS: BAFFLES Cl CONCRETE Cl CAST IRON ❑ PLASTIC ❑
HEEDS NEW LID? 11 YES SIZE
J GROUND COVER OVER TANK
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L� COMMENT ON CONDITION OF DRAINFIE' O ETC.
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SIGNED BY DATE