Permit CITY OF T D SEWER CONNECTION
,xar11�j DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT # • SW R98 -0092
DATE ISSUED: 07/28/98
PARCEL: 1S126DC -06500
SITE ADDRESS...:O9275 SW LOCUST ST
SUBDIVISION •MLP96 -0014 PP1997 -124 ZONING: R -12
BLOCK LOT •001 JURISDICTION: TIG
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: sf sewer for 9275 SW Locust St
Owner: FEES
BERT LUNDMARK type amount by date recpt
3381 COEUR D' ALENE DRIVE PRMT $ 2300.00 GEO 07/28/98 98- 307786
WEST LINN OR 97068 INSP $ 35.00 GEO 07/28/98 98- 307786
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 -0010 through OAR 952-8a81-0080. You may obtain copies of
these rules or direct questions to i,i_, by calling (503)246 -1987.
Issued by: /7„ � ii�i Permittee Signature:
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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