Permit CITY TIGARD SEWER CONNECTION PERMIT
4 DEVELOPMENT SERVICES PERMIT #: SWR1999 -00085
-f � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/8/99
SITE ADDRESS; 14111 SW 120TH PL PARCEL: 2S110BB RED03
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
TENANT NAME: FOUR D CONSTRUCTION
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: Sewer connection for new single family dwelling.
Owner:
FEES
FOUR D CONSTRUCTION
PO BOX 1577 Type By Date Amount Receipt
BEAVERTON, OR 97075 PRMT BON 7/8/99 $2,300.00 99- 316687
INSP BON 7/8/99 $35.00 99- 316687
Phone: Total $2,335.00
Contractor:
G + B PLUMBING
PO BOX 1269
HILLSBORO, OR 97123 -1269
Phone: 640 -5770
R� #: LIC 00000199
PLM 31 -
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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: (! A ,t7/' Permittee Signature:
C I (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 7/8/99999 00085
--- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 14111 SW 120TH PL PARCEL: 2S110B6 - RED03
SUBDIVISION: REDWOOD VISTA ZONING: R - 4.5
BLOCK: LOT: 003 JURISDICTION: TIG
TENANT NAME: FOUR D CONSTRUCTION
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: Sewer connection for new single family dwelling.
Owner: FEES
FOUR D CONSTRUCTION Type By Date Amount Receipt
PO BOX 1577
BEAVERTON, OR 97075 PRMT BON 7/8/99 $2,300.00 99- 316687
INSP BON 7/8/99 $35.00 99- 316687
Phone: Total $2,335.00
Contractor:
G + B PLUMBING
PO BOX 1269
HILLSBORO, OR 97123 -1269
Phone: 640 -5770
Reg #: LIC 00000199
PLM 34 -44PB
Required Inspections
Sewer Inspection
ORIGINAL
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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: gmttjui_____
Permittee Signature: r4A i m t i OJ1
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b iness day