Permit A o: CITY OF TIGAR[ i,R! I � � SEWER CONNECTION PERMIT
l DE VELOPMENT SERVICES ' r u A PERMIT #: SWR2000 -00136
- / ATE ISSUED: 06/26/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 15215 SW 107TH TERR PARCEL: 2S110DA EH051
SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5
BLOCK: LOT: 051 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: S/F PATH I
Owner: FEES
RENAISSANCE CUSTOM HOMES INC Type By Date Amount Receipt
1672 SW WILLAMETTE FALLS DRIVE
WEST LINN, OR 97068 PRMT KJP 06/26/200C $2,300.00 0003259
INSP KJP 06/26/200C $35.00 0003259
Phone: 503 - 557 -8000 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
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 of these rules or direct questions to OUNC by calling (503) 246,1987.
Issued by: / Permittee Signa r Y r
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the • business day