Permit ^ • CITY OF TI GARD WER CONNECTION PERMIT
,r DEVELOPMENT SERVICES Q R l G I N 4,L ERMIT #: SWR1999 -00264
' 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 ISSUED: 02/15/2000
SITE ADDRESS; 12208 SW SWEENEY PL PARCEL: 2S103A6 -05300
SUBDIVISION: WALNUT GLEN ZONING: R -4.5
BLOCK: LOT: 011 JURISDICTION: TIG
TENANT NAME: WALNUT GLEN
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 for new SF.
Owner: FEES
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140
BEAVERTON, OR 97006 PRMT GEO 02/15/200C $2,300.00 00- 321710
INSP GEO 02/15/200C $35.00 00- 321710
Phone: 645 -0986 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 • ales oft - -e r -s or direct questions to OUNC by calling (503) 246 -1987.
� / Issued by: �i � Permittee Signature: 1 45 / 7
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day