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Permit i _. i 7 CITY SEWER CONNECTION PERMIT ` ` COMMUNITY DEVELOPMENT PERMIT #: SWR2008 - 00152 TIGARp- 1 3125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/6/2008 PARCEL: 1 S134AB -03300 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD ZONING: R - 12 SUBDIVISION: MUSLIM EDUCATIONAL TRUST LOT: JURISDICTION: TIG PROJECT: MUSLIM EDUCATIONAL TRUST Project Description: .5 EDU increase TENANT NAME: MUSLIM EDUCATIONAL TRUST CWS NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: 0.5 TYPE OF USE: CMS NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Owner: MUSLIM EDUCATIONAL TRUST INC FEES PO BOX 283 Description Date Amount PORTLAND, OR 97223 [SWUSA] Sewer Connection Fee 11/6/2008 $1,550.00 Phone: Total $1,550.00 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 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 lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -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. ■ i f Issued .y: � A A/ .1 , �` /�� � � 7 ' Permittee Signature: r _____.---;- r Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. 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