Permit -P CITY OF TIGARD
SEWER CONNECTION PERMIT
:
('7
ll :. COMMUNITY DEVELOPMENT PERMIT #: SWR2008 -00003
*' DATE ISSUED: 1/9/2008
TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 CA - 00800
SITE ADDRESS: 09900 SW SATTLER ST ZONING: R -7
SUBDIVISION: ALDERBROOK FARM LOT: 009 JURISDICTION: TIG
PROJECT: EVEN
Project Description: Connect existing house to sewer service. Septic tank is to be pumped, filled and inspected.
Reimbursement District #27 fee paid this date.
TENANT NAME:
CWS NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1.0
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Owner: FEES
EVEN, MARC ROBERT /MICHELLE ANNE
WIEBE, MACK/MEREDITH S Description Date Amount
9900 SW SETTLER ST
TIGARD, OR 97224 [SWUSA] Sewer Connection Fee 1/9/2008 $2,800.00
[SWINSP] Sewer Inspection Fee 1/9/2008 $35.00
Phone: 503- 806 -4795
Total $2,835.00
Contractor:
Contact #: REQUIRED ITEMS AND REPORTS
Reg #:
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 0 days from the
date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the ac uracy of the side sewer
laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions f om the distance given.
If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. ATTEN1jION: Oregon
law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR' 952-0 1 -0010 through
OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or "1,800 332.2344.
Issued by: Permittee Signature: 7 I —
Call 503.639.4175 by 7:00 a.m. for an inspection that busin ss day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.