Permit CITY OF T SEWER CONNECTION
0j.11' DEVELOPMENT SERVICES PERMIT #PERMIT¢ : WR - r— 2e;
DATE ISSUED: 07/30/97
PARCEL: 25111CB- -ULW03
SITE ADDRESS...:1OO6O SW LADY MARION DR
SUBDIVISION.,..:ULWELLING MLP96 -0015 ZONING: R -3.5
BLOCK.......... LOT .............:003 JURISDICTION: TIG
TENANT NAME.....:RANDALL C MYERS INC
USA FIXTURE UNITS,..: 0
CLASS OF WORK...: NEW DWELLING UNITS..: 1'
TYPE OF USE. ....:SF NO. OF BUILDINGS: 1.
INSTALL TYPE.._.:BUSWR IMPERV SURFACE: 0 s
Remarks: SF — Path 1
Owner : ------- - - - - -- • - - - - - -- FEES - - --
RANDALL C MYERS INC type amount by date recpt
6655 SW HAMPTON OUL $ 210.00 B 07/30/97 97- 297771
PORTLAND OR 97223 GUN $ 290.00 B 07/30/97 97- 297771
PRMT $ 2200.00 B 07/30/97 97- 297771
Phone #: INSP $ 35.00 B 07/30/97 97- 297771
EROS $ 88.00 B 07/30/97 97- 297771
Contractor: ----------- -------- ..ERPU $ 28.60 B 07/30/97 97- 297771
RANDALL C MYERS INC ERPC $ 28.60 B 07/30/97 97- 297771
6655 SW HAMPTON ST
#100
PORTLAND OR 97223 -8358 --- -- • ------- __.___._ - ._— _ -___—
Phone #: 639 -9054 $ 2880.20 TOTAL
Reg #..: 000489 . •
--• REQUIRED INSPECTIONS --- -- - - --
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires l80 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 -00i -0010 through OAR 952 - 0001 -0080. You nay obtain copies of ii •
these rules or direct ,- ~estions to OUNC by calling (503)246 -1987.
•
Issued by ' L Permittee Signature
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Call 639 -4175 by 6:00 p. m. for an inspection needed the \ next bus: - ,ess day
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