Permit •
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ill CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT PERMIT #: SWR2008 -00064
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/8/2008
PARCEL: 25101 DB -00609
SITE ADDRESS: 07665 SW FIR ST ZONING: R -3.5
SUBDIVISION: ROLLING HILLS LOT: 017 JURISDICTION: TIG
PROJECT: GUTHRIE
Project Description: Connect existing house to sewer service. Sewer Reimbursement District #44 fee paid this date.
TENANT NAME:
CWS NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1.0
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Owner: FEES
GEORGE & D GUTHRIE
7665 SW FIR ST Description Date Amount
TIGARD, OR 97223
[SWUSA] Sewer Connection Fee 5/8/2008 $2,800.00
[SWINSP] Sewer Inspection Fee 5/8/2008 $35.00
Phone: 503- 639 -5421 Total $2,835.00
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.
Issued y: _ O , , .. IA_ 1 .1 Permittee Signature:
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Call 503.639.4175 by 7:00 a.m. for an inspection that business 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.