Permit C ITY OF TI GARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2003 -00120
����I DATE ISSUED: 5/13/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 13672 SW LEAH TERR PARCEL: 2S109BA 07900
SUBDIVISION: DAFFODIL HILL ZONING: R -
BLOCK: LOT: 005 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF.
Owner: FEES
HEIGHTS CONSTRUCTION
PO BOX 91249 Description Date Amount
PORTLAND, OR 97291 [SWUSA] Swr Connect 5/13/03 $2,300.00
[SWUSA] Swr Connect 5/13/03 $0.00
Phone: 503- 29 -2550 [SWINSP] Swr Inspect 5/13/03 $35.00
[SWINSP] Swr Inspect 5/13/03 $0.00
Contractor:
Total $2,335.00
Phone:
Reg #:
Required Inspections
•
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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" Perm
Issu d by: ,��� Permittee Signature: x
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day