Permit CITY TIGARD SEWER CONNECTION PERMIT
x DEVELOPMENT SERVICES PERMIT #: SWR2004 -00310
�� 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/2004
SITE ADDRESS; 09600 SW FREWING ST PARCEL: 2S102CD -00400
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R - 4.5
BLOCK: LOT: 025 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: New sewer connection.
Owner: FEES
DOWD, LARRY + LAURA
9600 SW FREWING Description Date Amount
TIGARD, OR 97223 [SWUSA] Swr Connectic 10/25/2004 $2,500.00
[SWUSA] Swr Connectic 10/25/2004 $0.00
Phone: [SWINSP] Sewer Inspeci 10/25/2004 $35.00
[SWINSP] Sewer Inspeci 10/25/2004 $0.00
Contractor:
Total $2,535.00
LANDFIX CONSTRUCTION
744 WISTERIA ST
INDEPENDENCE, OR 97351
Phone: 503- 302 -8211
Reg #: LIC 161275
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•u
may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699. � /
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Issued by: �o � C Permittee Signature: _A /
Call (503) 639 -4175 by 7:00 P.M. for an inspection need-0 e next busine