Permit CITY TIGARD SEWER CONNECTION PERMIT
I'� DEVELOPMENT SERVICES PERMIT #: SWR2000 -00044
'I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/23/00
SITE ADDRESS; 15865 SW 74TH AVE 100 PARCEL: 2S112DC 01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
TENANT NAME: GREENLINE INC
USA NO: FIXTURE UNITS: 31
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Sewer permit associated with Plumbing TI. Credit of 1 EDU applied to this permit. Total FU's = 15
or 1 EDU charged to this permit.
Owner: FEES
PACIFIC REALTY Type By Date Amount Receipt
15350 SW SEQUOIA PKWY
SUITE 300. PRMT GEO 3/23/00 $2,300.00 0000876
TIGARD, OR 97223 Total $2,300.00
Phone:
Contractor:
Phone:
Reg #:
Required Inspections
F/' /9L-
ORtGINAL
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- 001 -0080.
You may obtain copi-s of • -se rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: A .4" `� , i Permittee Signat
• Call (503) 639 -4 75 by 7:00 P.M. for an inspection needed the next business day