Permit . A CITY OF TIGARD SEWER CONNECTION PERMIT
A-tio r� D EVELOPMENT SERVICES �.` PERMIT #: SWR2000 -00066
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DATE ISSUED: 04/17/2000
13125 SW Hall Blvd., Tigard, OR 97 223 (503) 639 - 417
SITE ADDRESS; 15132 SW 84TH AVE PARCEL: 2S112C;6 -HCO26
SUBDIVISION: HAMPTON COURT ZONING:.. R -7
BLOCK: LOT: 026 JURISDICTION: TIG
TENANT NAME: LEGEND HOMES
USA NO: - . - FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF • NO. OF BUILDINGS:, 1 •
INSTALL TYPE: LTPSWR IMPERV SURFACE:
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Remarks: Sewer connection •
Owner: FEES
LEGEND HOMES
12755 SW 69TH Type By Date Amount Receipt
TIGARD, OR 97223 INSP KJP 04/17/200C $35.00 0001470
PRMT KJP 04/17/200C $2,300.00 0001470 .
Phone: 503 - 620 -8080 Total $2,335.00
Contractor:
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Phone:
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Reg #: • •
Required Inspections
, • _ Sewer Inspection
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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 co of these rules or direct questions to OUNC by calling (503) 246 -1987. •
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Issued by: Permittee Signature: /�jr ` a
Call (503) 639 -4175 by 7:00 P.M. for an inspection •needed the next busine = s day.