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Permit 71 n CITY OF TIGARD SEWER CONNECTION PERMIT ° . COMMUNITY DEVELOPMENT PERMIT #: SWR2006 - 00095 , TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/12/2007 PARCEL: 2S 102DC - 00302 SITE ADDRESS: 09240 SW O'MARA ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: 016 JURISDICTION: TIG PROJECT: FISHER Project Description: Connect existing house to sewer lateral. In Reimbursement District #23. TENANT NAME: CWS NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1.0 • TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Owner: FISHER, ANTHONY FEES 1300 GLENMORRIE DR Description Date Amount LAKE OSWEGO, OR 97034 [SWUSA] Sewer Connection Fee 3/9/2007 $2,600.00 [SWINSP] Sewer Inspection Fee 3/9/2007 $35.00 Phone: 503 -710 -0687 Total $2,635.00 Contractor: REQUIRED ITEMS AND REPORTS Contact #: Reg #: 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" 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 - 001 -0100. You may obtain co.' - . e • -se rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. . r 110 -..... -sued by: _ & I /, LI Permittee Si , natu o , 41! Call 503.639.4175 by 7:00 a.m. for an inspection t business d . 4 This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • Fees Associated With 5/31/2006 8:25:46AM Avo 1 Case #: SWR2006 -00095 City of Tigard Fee Start End Revenue Created Type Date Date Dept Description Account Number By Date Amount Due PRMT 1/1/1990 12/31/2020 [SWUSA] Sewer Connection Fee 500- 0000 - 207000 DEB 5/22/2006 2,600.00 2,600.00 INSP 1/1/1990 12/31/2020 [SWINSP] Sewer Inspection Fee 245 -0000- 441001 DEB 5/22/2006 35.00 00 Total: $2,635:00 • • • Page 1 of 1 CaseFees..rpt 9240 S.W. O'MARA . I BUILDING ELEVATION 196.0' 9240 S.W O'MARA I cu N N Z . c N J C13. J r"i 1-1-: O 0 O . 1 / 1 d- N }^ Q 11 G + �r Install n —I n p cleanout Q 0 .4�� J , `n N A [ J ' frorq 1 proertyline `1 Q II �� 0 EX. CB 5 . ors J►� (o . W II - - RIM=188. 95 9 "TO o) IE =18 7.00 — — -- \ � — — - — -- — E c �' — �, ' M c M i i_....., i1: ► � �, -� i1 S © G S 4 + lr)^ 4 ■ ► d- N co ■ ► ' C0 4 5+00 . 4 —.Eh'. MH - i t . RIM=188. 51 ,r-.-,,,,11,,_10,, n :