Permit CITY OF TIGARD
44,.. CONNECTION
DEVELOPMENT SERVICES SEWER
PERMIT
!+� 13125 SW Hall Blvd., Tigard, OR 97223 503 639.4171
PERMIT # • SW R97 -0415
DATE ISSUED: 12/05/97
PARCEL: 2S104DB -04100
SITE ADDRESS...:13139 SW WELLINGTON PL
SUBDIVISION •AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT °041 JURISDICTION: TIG
TENANT NAME •
USA NO • FIXTURE UNITS...: 0
CLASS OF WORK... :NEW DWELLING UNITS..: 1
TYPE OF USE °SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: PATH 1: New single family dwelling w /attached garage.
Owner: FEES
OAK KNOLL CONSTRUCTION INC type amount by date recpt
4035 SW DOUGLAS WAY PRMT $ 2200.00 B 12/05/97 97- 301465
LAKE OSWEGO OR 97035 INSP $ 35.00 B 12/05/97 97- 301465
Phone #:
Contractor:
OWNER
Phone #: $ 2235.00 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 (503)246 -1987.
•
Issued by: ' Permittee Si gnat -/ /j' 1.0i2)
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++