Permit CITY OF TIGARD R\G\ NAt E WER CONNECTION PERMIT
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L 5 • � 1 �, DEVELOPMENT SERVICES DATE ISSUED: 01/18/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: SWR1999
639-4171
SITE ADDRESS; 13006 SW ROCKINGHAM DR PARCEL: 2S104DB -03300
SUBDIVISION: AMESBURY HEIGHTS ZONING: R -4.5
BLOCK: LOT: 033 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection
Owner: FEES
ACCENT RESIDENTAIL HOMES INC Type By Date Amount Receipt
12916 SW WILINGTON LN
PO BOX 230655 PRMT GEO 01/18/200C $2,300.00 00- 321181
TIGARD, OR 97281 INSP GEO 01/18/200C $35.00 00- 321181
Phone: 503 - 670 - 4939 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
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 952 - 001 -0080.
You may obtain copies of th- e rules .r direct questions to OUNC by calling (503) 24- -1987. •
Issued by: �/ Ii �/ / Permittee Signature: �; ''�Tr�� '
Call (503 • 9 -4175 by 7:00 P.M. for an inspection needed the n business day