Permit C ITY OF TIGARD
SEWER CONNECTION PERMIT
; DEVELOPMENT SERVICES PERMIT #: SWR2004 -00354
_.�W W 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -41 DATE ISSUED: 1/11/2005
SITE ADDRESS; 16055 SW 108TH AVE 100 CLUB HOUSE PARCEL: 2S115AA -OTOOA
SUBDIVISION: OAK TREE APARTMENTS ZONING: R - 25
BLOCK: LOT: OOA JURISDICTION: TIG
TENANT NAME: OAK TREE II APARTMENTS
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Building F - Clubhouse. 3.1 edu's. Demo credit of 1 edu.
Owner:
FEES
OT2 LLC Description Date Amount
5437 ROSALIA WAY SUITE 100
LAKE OSWEGO, OR 97035 [SWUSA] Swr Connectic 1/11/2005 $7,750.00
[ SWUSA] Swr Connectic 1/11/2005 $0.00
Phone: 503- 620 -4373
Total $7,750.00
Contractor:
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"
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 -0100. You
may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
Issued 4110 _ ! ~1V / I ,I,A 2 _2,_ Permittee Signature: 41111rA
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the -xt business day