Permit CITY TIGARD SEWER CONNECTION PERMIT
�I� DEVELOPMENT SERVICES PERMIT #: SWR2004 -00025
���
Alt DATE ISSUED: 2/27/04
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 08392 SW COLTON LN PARCEL: 2S1120C D0007
SUBDIVISION: DURHAM OAKS ZONING: R -12
BLOCK: LOT: 007 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner:
FEES
BUENA VISTA HOMES
6932 SW MACADAM #C Description Date Amount
PORTLAND, OR 97219 [SWUSA] Swr Connect 2/27/04 $2,400.00
[ SWUSA] Swr Connect 2/27/04 $0.00
Phone: 503- 443 -6033 [SWINSP] Swr Inspect 2/27/04 $35.00
[SWINSP] Swr Inspect 2/27/04 $0.00
Contractor:
Total $2,435.00
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 by: / Permittee Signature: _
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day