Permit CITY TIGARD SEWER CONNECTION PERMIT
\i,4 I y DEVELOPMENT SERVICES PERMIT #: SWR2003 -00233
, DATE ISSUED: 11/3/03
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 10850 SW BRIARWOOD PL PARCEL: 1S133AC H6015
SUBDIVISION: HAWK'S BEARD TOWNHOMES ZONING: R - 25
BLOCK: LOT: 015 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SFA dwelling.
Owner:
FEES
•
AUTUMN PARK TOWNHOMES, LLC Description Date Amount
9500 SW BARBUR BLVD., STE 220
PORTLAND, OR 97219 [SWUSA] Swr Connect 11/3/03 $2,400.00
[SWUSA] Swr Connect 11/3/03 $0.00
Phone: 503- 892 -8758 [SWINSP] Swr Inspect 11/3/03 $35.00
[SWINSP] Swr Inspect 11/3/03 $0.00
Contractor:
Total $2,435.00
Phone:
Reg #:
Required Inspections
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" Perm
C.,
Issued , .." Permittee Signature: _ t elie
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day