Permit CITY OFTIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
�� PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #.......: SWR97 -0410
DATE ISSUED: 12/15/97
PARCEL: 25111DA —APW1O
SITE ADDRESS...:O8736 SW LODI LN
SUBDIVISION •APPLEWOOD PARK NO. 1 ZONING: R -7 PD
BLOCK LOT -010 JURISDICTION: TIG
TENANT NAME - LEGEND HOMES
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 — Path 1
Owner : FEES
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 2200.00 GEO 12/15/97 97- 301726
TIGARD OR 97224 INSP $ 35.00 GEO 12/15/97 97- 301726
Phone #:
Contractor: --
OWNER
Phone #: $ 2235.00 TOTAL
Reg #..
REQUI RED INSPECT
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
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
952401 -0010 through OAR 952 -0001 -0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued b Permittee S ign ature: ; � 1
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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