Permit .
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CITY OF TIGARD SEWER CONNECTION
DEVELOPMENT �~u~�u~u~��n x�nm~n� n ��u�ox~n��m~�� PERMIT
AA 1— t3125ON/ Hall 8h�, Tigard, ORQ7221(503)639-4/7/ PERMIT # ^ SWR98-0294
DATE ISSUED: 11/23/98
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PARCEL: 26110AB-05700
SITE ADDRESS...:11430 SW JACKIE CT
SUBDIVISION -HAWK MEADOWS ZONING: R-4.5
BLOCK LOT...... .... ...:010 JURISDICTION: TIG
TENANT NAME -FOUR 'D' CONSTRUCTION CO
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
FOUR 'D' CONSTRUCTION CO * type amount by date recpt
PO BOX 1577 PRMT $ 2300.00 JSD 11/23/98 98-311034
BEAVERTON OR 97075 INSP $ 35.00 JSD 11/23/98 98-311034
Phone #:
Contractor: -
FOUR D CONSTRUCTION
PO BOX 1577
BEAVERTON OR 97075
Phone #: 590-0805 $ 2335.00 TOTAL
Reg #..: 000710 �
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. 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 Sower" 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-m1-mv You may obtain copies of
these rules or direct questions to O0NC by calling (503)246-1987.
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Issued by -~�� __ Signature: _~_, �, '
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Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
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