Permit .
A, CITY OF TIGARD
DEVELOPMENT SEWER CONNECTION
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PERMIT
����� 13125 SW Hall Blvd., � — ~--' ''—' PERMIT #.......: SWR96-0491
DATE ISSUED: 07/21/97
PARCEL: 2S104CA-02900
SITE ADDRESS...:13520 SW LAUREN LN '
SUBDIVISION....:HILLSHIRE ZONING: R-7 PD
BLOCK LOT.............:029 JURISDICTION: TIG
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TENANT NAME.....:
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: Path 1
Owner: — FEES --- —
DEVAN BOTEL type amount by date recpt
15444 SE GRANT ST PRMT $ 2200.00 DRA 07/21/97 97-297387
PORTLAND OR 97223 INSP $ 35.00 DRA 07/21/97 97-297387
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Phone #:
Contractor: ----------
OWNER
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Phone #: $ 2235.00 TOTAL
Reg #..:
REQUI RED 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-va through OAR 952-00011080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246-1987. _
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Issued ' /���^��� � ____ Per /ittee Signature / _____
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Call 639-4175 by 6:00 p.m. for an inspection needed the next business day
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