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Permit CITY TIGARD SEWER CONNECTION PERMIT i0I DEVELOPMENT SERVICES PERMIT #: SWR2003 -00335 '�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/18/03 SITE ADDRESS; 12665 SW 69TH AVE PARCEL: 2S101AD -02800 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 031 JURISDICTION: TIG TENANT NAME: ENYEART OFFICE BUILDING USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: 3.9 EDU increase, new office building. Owner: FEES CEDAR ENTERPRISES Description Date Amount MARTY GOLDSMITH & RON ENYEART 4004 KRUSE PLACE [SWUSA] Swr Connect 9/18/03 $9,360.00 LAKE OSWEGO, OR 97035 [SWUSA] Swr Connect 9/18/03 $0.00 Phone: [SWINSP] Swr Inspect 9/18/03 $45.00 [ SWINSP] Swr Inspect 9/18/03 $0.00 Contractor: Total $9,405.00 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 /* Issued by: Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day