Permit „
CITY OF TIGARD
SEWER CONNECTION PERMIT
Pillt' DEVELOPMENT SERVICES l o o RMIT #: SWR1999 -00208
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 1 . ` UED: 2/29/00
SITE ADDRESS; 12801 SW 113TH PL *$, PARCEL: 2S103AC -FON01
SUBDIVISION: FONNER WOODS ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
TENANT NAME: STEVE TURNER
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 single family dwelling.
Owner:
FEES
STEVE R. TURNER Type By Date Amount Receipt
8835 SW CANYON LANE
#408 PRMT DEB 2/29/00 $2,300.00 00- 321901
PORTLAND, OR 97225 INSP DEB 2/29/00 $35.00 00- 321901
Phone: 503 - 292 -5920 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 n-ii. *lay Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 9 001 -0080.
You ay obtain co• . es of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issu by �, 1 ,/ _i , � j • /# ! 1 Permittee Signature: , Via!% ,f,
` '
Call (503) 6 9 -4175 by 7:00 P.M. for an inspection needed the next b si !s d ay