12890 SW 135TH AVENUE DSW /
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SEWER CONNECTION
CITYOF TIGrARD PE R01 I T'
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commu ) PERMIT #. . . . . . . : SWR9L-0292
4rY DEVELOPMENT DEPARTMENT 0R100H
13125 SW HWI Blvd, P.O.Box 23397,Tiqwd,Oregon 97223(503)639-4175
639-4 1-1*1 DATE ISSUED: 09/17/9a
SITE ADDRESS. . . . 12690 SW 135TH AVE PARCEL: 2SI04BD-03100
SUBDIVISION. . . . : HANDY ACRES ZONING: R-6
LALOC k. . . . . . . . . . : LOT. . . . . . . . . . . . :32
-------------------------------------------- ..............
TENANT NAME. . . . .
USIA IVO. . . . . . . . . . : FIXTURE UNITS— ;
CLASS OF' WORK. . . :NF_W DWELLING UNITS. . : 1
TYPE OF USE.. . . . . :SF= NO. OF BUILDINGS: l
INSTk!-L TYPIE. . . . :BUSWR IMPERV SURFACE. .
Remarks : Connect SFD in L,v ed unto r- o per-t y to sewer.
O vrter.:
ewet-
O ,jiwet,: FEES
LARRY WESFERMAN type aniol.int by date reupt
13665 SW FERN ST PIRMr 1, 2100. 00 PILL
I N S P 30. 00 FILL A69/17/92
TIGARD, OR 97223
Pf-ione #: I-t*97-2292
OWNER
2135. 00 T*0TA1-
REUUIRED INSPECTIONS
This Applicant Agrees to comply witn all the rules and regulations Sewer- Inspection
of the Unified Sewage Agency. The permit expires M 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, thk installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
Pf,r,in i t t e e S i gnat 1.1r, %&4YAAi4
Issi-il?d By : C4a(z
Call for- inspection 639-4175
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C I tY OF 71 CIARD - RE f F [FST OF V,AYMF"NT RE.(".E":I.V.T NO. :9P--231750
CHECK i:)MOUN"' a 2135. 00
Nf)ME : WF STERMAN, JOIDY & LARRY COSH AMOU61T a �j. L71
ADDRESS; : 13665 Earl FERN 4:jTPFET MYMENT DATE : 09/17/9c'
SL..)E)DIVISTON
710-1.111D,C31•111D, OR 1)7223-- 1511
PURPOSE OF PAYMV19T ONOUNT PAID PURPMF OF P*(-)'(MFAMOUNT E--'AIU
_....._._
•".
;'E, --R t jf.3A r'100. 00 E'FWFR i NEsPEC"T 35. 00
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SEWF=R PERMIT 09P--@292
n)Ml. AMOUNT PAID -? r.'1,t . 00
sEiYu SEIYU INTERNATIONAL
TEL: (503) 245-4090• (503)245-4435 FAX (503) 245-4351
date : alGLl
To. whom it may concern ;
4&fx-,t_04j__al_Pl���c= pt& of
has contributed to our satisfaction an the public sewer line that
we have installed on 135th Avenue , Tigard .
Project # 89340
Summit at Bull Mountain , Phase I
This letter is to serve as a "Letter of Participation" concerning
the above public sewer line project .
Sincerely,
' Kurt VanVclkenburgh
r�
General Manager
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Lincoln Center 10220 S.W. Greenburg Suite 450 Portland. Oregon 97223