Permit CITY OF TIGARD
A
DEVELOPMENT SERVICES SEWER CONNECTION
PERMIT
=-.- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #.......: SWR97 -0286
DATE ISSUED: 07/30/97
PARCEL: 28111CB-ULW02
SITE ADDRESS...a1OO42 SW LADY MARION DR
SUBDIVISION.... :ULWELLING MLP96 -0015 ZONING: R -3.5
BLOCK.-- . -..a.. LOT.=.- . ........ :OO2 JURISDICTION: TIC
TENANT NAME.....:RANDALL MYERS INC
USA NO . FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE..... :SF NO. OF BUILDINGS: 1
INSTALL TYPE.... :BUSWR IMPERV SURFACE: 0 sf
Remarks: New SFD
Owner: ----------- _. ---- - - - - -- FEES - --
RANDALL MYERS INC type amount by date recpt
6655 SW HAMPTON OUL $ 210.00 B 07/30/97 97-297772
PORTLAND OR 97223 QUN $ 290.00 B 07/30/97 97-297772
PRMT $ 2200.00 B 07/30/97 97- 297772
Phone #: INSP $ 35.00 B 07/30/97 97- 297772
EROS $ 88.00 B 07/30/97 97- 297772
Contract or 2 - - - - -- -- ERPU $ 28. 60 B IZ17/3O/97 97- 297772
RANDALL C MYERS INC ERPC $ 28.60 B 07/30/97 97- 297772
6655 SW HAMPTON ST
#100
PORTLAND OR 97223 -8358. . -- ---- --
Phone #: 639 -9054 $ 2880.`0 TOTAL
Reg #.. a 000489
- -- REQUIRED INSPECTIONS -----
Applicant agrees to comply with all the rules and regulations Sewer Inspection _____
of the Unified Sewage Agency. The permit expires 188 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 I �,
a "Tap and Side Sewer" Permit and the Agency will install a lateral. __, I _ -- _
ATTENTION; Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR ____-
952 - 801 -0010 through OAR 952- 01-0080. You may obtain copies of ti
these rules or dire t questions to OUNC by calling {503 -1987. I, _
Issued byo� V �.-- ' _ Permittee. Signatures 1116._ -_
j — _
- 1-+++++++++++++++4-+++- i-++++ + ++++ + ++ + ++++++ + ++ + ++++-1 -+-1-+ 4-4-4-1-++++++4.4-4-1-- -1-4-44-++++++++
- ++ + + + + ++
Call 639 -4175 by 6:00 p. m. for an inspection needed the next busi less day
+++ + + ++4-4 - 1-+++++- F++- F+ F•+- 1-+++++ + + + + +-1- + ++ + + + ++ + + + + +-I- +-h ++ ++ + + + ++ + + + +-1•+ r ± + + +-I + +- I- + ++ -6-+