Permit CITY OF TIGARD
A
ty., t DEVELOPMENT SERVICES SEWER CONNECTION
/��nn;d �j PERMIT
= -.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -41 PERMIT #
: SW R 98— 314
DATE ISSUED: 01/08/99
PARCEL: 1S125CD -07800
SITE ADDRESS... :09959 SW LANDAU PL
SUBDIVISION....:TIGARD WOODS ZONING: R -4.5
BLOCK...- ...... LOT ............. :004 JURISDICTION: TIG
TENANT NAME.....:BEACON HOMES INC .
USA NO..........: FIXTURE UNITS...: 0
CLASS OF WORK...: NEW DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1
INSTALL TYPE...- :l_TPSWR IMPERV SURFACE: 0 sf
Remarks: Sewer connection for a new single family dwelling.
Owner: - _________.__...______ __._._________.____..___._.___. _.__.________ FEES
BEACON HOMES INC type amount by date recpt
9500 SW 125TH AVE PRMT $ 2300.00 GEO 01/08/99 99- 312043
BEAVERTON OR 97008 INSP $ 35.00 GEO 01/08/99 99- 312043
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. _
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001- m10 through OAR 952- 0001 -0080. You may obtain copies of ,..
these rules or direct questions t (MC by calling (503)246 -1987. / ......_
Issued by:. �� / -- Permittee Si nature� ' i��
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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