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
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Issued by: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day