Permit •
CITY TIGARD SEWER CONNECTION PERMIT
11 DEVELOPMENT SERVICES . PERMIT #: SWR2001 -00029
r ' I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/21 /2001
SITE ADDRESS; - 16001 SW 81ST PL • PARCEL: 2S112CC -14400
SUBDIVISION: DURHAM SC HOOL PARK ZONING: R -12
BLOCK: LOT: 006 • JURISDICTION: TIG
TENANT NAME:
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 permit for new single family residence.
Owner: _
FEES
HERB HOFFART & CO - Type By - Date Amount Receipt
4632 SW VERMONT ST •
PORTLAND, OR 97219 PRMT CTR 02/21/2001 $2,300.00 27200100000
• INSP CTR 02/21/2001 $35.00 27200100000
Phone: 503- 244 - 0876 Total $2,335.00
Contractor:
•
Phone:
Reg #:
Required Inspections
•
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 copies of these rules or direct questions to OUNC by calling (503) 246 - 1987.
iff
Issued by: . Permittee Signature: if
3) 639 -4175 by 7:00 P.M. for an inspection needed the next busines. /�y .