Permit A CITY OF TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2002 -00052 •
� I�' � DEVELOPMENT H BMEN9 Tigard, OR SERVICES 2 639 -4171 DATE ISSUED: 8/29/02
SITE ADDRESS; 13088 SW PRINCETON LN PARCEL: 2S104DA -20100
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R -4.5
BLOCK: LOT: 027 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection
Owner: FEES
BROWNSTONE QUAIL HOLLOW LLC
12670 SW 68TH PKWY STE 200 Type By Date Amount Receipt
PORTLAND, OR 97223 PRMT CTR 8/28/02 $2,300.00 27200200000
INSP CTR 8/28/02 $35.00 27200200000
Phone: 503 - 598 -7565 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations 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 -001 -0080.
You may copies of these rules or direct questions to OUNC by calling (503) 2 987. ma
Wi
Issued Perm ittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day