Permit CITY OF TIGARD
A,
DEVE LOPMENT SERVICES SEWER CONNECTION
d wrlpl� j�� PERMIT
AIL 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # ° SW R98 -0275
DATE ISSUED: 11/04/98
PARCEL: 2511OAB -05600
SITE ADDRESS.. °:11450 SW JACKIE CT
SUBDIVISION -HAWK MEADOWS ZONING: R -4.5
BLOCK.......... LOT........ ..... :009 JURISDICTION: TIG
TENANT NAME - WILLIAMS, ALAN
• USA NO FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE °SF NO. OF BUILDINGS: 1
INSTALL TYPE °LTPSWR IMPERV SURFACE: 0 sf
Remarks: Sewer connection for a new single family dwelling.
Owner: - - -- ---- FEES
ALAN R WILLIAMSON type amount by date recpt
10895 SW AVOCET COURT PRMT $ 2300.00 DEB 11/04/98 98- 310561
BEAVERTON OR 97007 INSP $ 35.00 DEB 11/04/98 98- 310561
Phone #: 351 -7491
Contractor:
OWNER
Phone #: $ 2335.00 TOTAL
Reg #..:
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 1 : 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 - 0001 -0080. You may obtain copies of •
these rules 1 t questions to OUNC by calling (503)246 -1987.
•
Issued by 00&44)4: Permittee Signature: 44A �/f�5L--
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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