Permit •
CITY OF TIGARD
410 0011W 1 1 \ DEVELOPMENT SERVICES SEWER CONNECTION
• PERMIT
13125 SW Hall Blvd., Tigard, OR 97223(503) 639 -4171 PERMIT # o .SWR98 -0263
DATE ISSUED: 10/12/98
PARCEL: 2S104DB -02800
SITE ADDRESS...:13039 SW ROCKINGHAM DR DR
SUBDIVISION - AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT . -028 JURISDICTION: TIG
TENANT NAME -SLAVO SKORO
USA NO - FIXTURE UNITS...: 0
CLASS OF WORK... :NEW • DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1 •
INSTALL TYPE - LTPSWR IMPERV SURFACE: 0 sf
Remarks: New SFD •
.
Owner: FEES
SLAVO SKORO type amount by dat a recpt
2 SE CURTIS RD PRMT $ 2300.00 B 10/12/98 98- 309894
CLACKAMAS OR 97015 INSP $ 35.00 B 10/12/98 98- 309894
Phone #:
Contract or:
OWNER
Phone #: $ 2335.00 TOTAL
Reg #..
REQUIRED INSPECTIONS
This. Applicant agrees to comply with all the rules and regulations Sewer Inspection
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- m10 through OAR 952 -0001 -0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued by: Permittee Signature:
•
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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