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CITY O F TI GARD SEWER CONNECTION PERMIT
A.Apipe PERMIT #: SWR2003 -00377
- •�,L� DEVELOPMENT H BMENg Tigard, ) 639 -4171 DATE ISSUED: 2/2/04
SITE ADDRESS; 09830 SW PIHAS CT PARCEL: 1S135CD -KE218
SUBDIVISION: KALAMOIIKA NO.2 ZONING: R -12 '
BLOCK: LOT: 018 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
• ECK CONSTRUCTION INC
PO BOX 204 Description Date Amount
SHERWOOD, OR 97140 [SWUSA] Swr Connect 2/2/04 . $2,400.00
[SWUSA] Swr Connect 2/2/04 $0.00
Phone: 503- 625 -1305 [SWINSP] Swr Inspect 2/2/04 $35.00
[SWINSP] Swr Inspect " 2/2/04 $0.00
Contractor:
Total $2,435.00 ■
Phone:
Reg #:
Required Inspections
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ThisApplicant 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 ,
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Issued by: 5 l/[� Permittee Signature
Call (503)639 -4175 by 7:00 P.M. for an inspection . needed the next business day