Permit ...... CITY OF TIGARD
It i, DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT
PERMIT # • SWR98 -0329
DATE ISSUED: 12/14/98
PARCEL: 15135AD -05200
SITE ADDRESS...: 10735 SW SITKA ST
SUBDIVISION -TRENT TERRACE ZONING: R -12
BLOCK LOT -002 JURISDICTION: TIG
TENANT NAME •KIMCO PROPERTIES LTD
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: Sewer connection for a new single family dwelling•
Owner: FEES
KIMCO PROPERTIES LTD type amount by date recpt
22060 SE 442ND AVE PRMT $ 2300.00 DLH 12/14/98 98- 311494
SANDY OR 97055 INSP $ 35.00 DLH 12/14/98 98- 311494
Phone #:
Contractor:
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- 001-0010 through OAR 952 -0001 -0080. You may obtain copies of
these rules or direct questions to OUNC by calling 1503)246-1987.
Issued by: Permittee Si nature: / /�
Y 9
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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