Permit CITY OF TIGARD
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LL! 13125 SW Hall Blvd., Tigard, 0R 97223 (503) 639 -4171
PERMIT #H E RM I T SWR98— 188
DATE ISSUED: 09/25/98
PARCEL: 2S110AB —HM006
SITE ADDRESS...:11433 SW JACKIE CT
SUBDIVISION....:HAWK MEADOWS ZONING: R -4.5
BLOCK LOT °006 JURISDICTION: TIG
TENANT NAME •DARRELL AHL
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: New SFD
Owner: -- FEES
DARRELL AHL type amount by date recpt
14047 SW CAMDEN LN PRMT $ 2300.00 B 09/25/98 98- 309501
BEAVERTON OR 97005 INSP $ 35.00 B 09/25/98 98- 309501
Phone #: 644 -3064
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 (503)246 -1987.
I ssued by: 6041
Permittee Signature /,r /,��
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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