Permit A r 4 0 PERMIT
CITYOFTIGARD
��� DEVE LO PMENT SERVICES SEWER CONNECTION
i�Y,
_! '� .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 PERMIT # : SW R97 - 0394
DATE ISSUED: 12/16/97
& \,41) PARCEL: 2S101DA -00101
SITE ADDRESS...:13190 SW 68TH PKWY
SUBDIVISION •TRIANGLE CORPORATE PARK ZONING: C —P
BLOCK LOT •003 JURISDICTION: TIG
TENANT NAME :UNIVERSITY OF PHOENIX
USA NO • FIXTURE UNITS...: 21
CLASS OF WORK...:ALT DWELLING UNITS..: 1
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: RE: PLM97 -0435
Owner: FEES
GERDING /EDLEN DEVELOPMENT type amount by date recpt
4650 SW MACADAM AVE PRMT $ 2200.00 JSD 12/16/97 97- 301797
STE 200
PORTLAND OR 97201
Phone #:
Contractor:
OWNER
Phone #: $ 2200.00 TOTAL
Reg #.. :
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations
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 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 952-0801-0080. You may obtain copies of
these rules or direct questions to OUNC by . ling 1503)246 -1987.
d
Issued by: �i1 Permittee Signature•! ,�_ / —Ali
dr
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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