Permit CITY OF T SEWER CONNECTION
_ , ren � i � '� DEVELOPMENT SERVI PERMIT #PERMIT° : SWR9e -29
DATE ISSUED: 11/23/98
PARCEL: 26110AB -05800
SITE ADDRESS °..:11410 SW JACKIE CT
SUBDIVISION °HAWK MEADOWS ZONING: R -4.5
' BLOCK.......... LOT °. °.. °. °. °° °.:011 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 fora 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 -311 033
• BEAVERTON OR 97075 INSP $ 35.00 JSD 11/23/98 98- 311033 •
Phone #:
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 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.
ATTINfION: 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- 80. You may obtain copies of
these rules or direct questions to OUNC by calling (503) 46 -1987.
r
„or f'.. _
Issued b y: F e r m i t t e e Signature: , ,,.,r ��i.,,�,L,, .
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Call 839.4175 by 7:00 p.m. for an' inspection needed the next business day
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