Permit A ' CITY OF TIGARD SEWER CONNECTION PERMIT
v DEVELOPMENT SERVICES
PERMIT #: SWR2002 -00275
'`� `I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 D ATE ISSUED: 10/16/02
SITE ADDRESS; 13420 SW SANDRIDGE DR PARCEL: 2S105DD -03800
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
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 residence.
Owner:
FEES
D R HORTON
5125 SW MACADAM #145 Description Date Amount
PORTLAND, OR 97201 [SWUSA] Swr Connect 10/16/02 $2,300.00
[SWINSP] Swr Inspect 10/16/02 $35.00
Phone: 244 - 5322
Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
Issued by: AFL / , Permittee Signature: din ��/ / f 111:4&
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day