Permit C ITY OF TIGARD SEWER CONNECTION PERMIT
Er COMMUNITY DEVELOPMENT PERMIT #: SWR2006 - 00309
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/15/2007
7f08 PARCEL: 1 S125CA -03800
SITE ADDRESS: 07412 SW CEDARCREST ST ZONING: R - 4.5
SUBDIVISION: BOULEVARD HEIGHTS LOT: 016 JURISDICTION: TIG
PROJECT: LAWRENCE
Project Description: Sewer connection for new SF.
TENANT NAME:
CWS NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1.0
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Owner:
LAWRENCE RESOURCES INC FEES
6770 SW ALFRED ST Description Date Amount
TIGARD, OR 97223
[SWUSA] Sewer Connection Fee 2/15/2007 $2,700.00
[SWINSP] Sewer Inspection Fee 2/15/2007 $35.00
Phone: 503 975 - 6560 Total $2,735.00
Contractor: •
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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 or 1.800.332.2344.
Issue Permittee Signature: AlleA
Call 503.639.4175 by 7:00 a.m. for an inspection that busin- day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.