Permit OFTIGARD CITY
DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW HaII Blvd., Tigard, OR 97223 (503)639-4171 PERMIT
PERMIT #.......: SWR97 -0404
DATE ISSUED: 12/08/97
PARCEL: 2S111DA —APW11
SITE ADDRESS...:08720 SW LODI LN
SUBDIVISION °APPLEWOOD PARK NO. 1 ZONING: R -7 PD
BLOCK LOT -011 JURISDICTION: TIG
TENANT NAME - LEGEND HOMES
USA NO FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1
INSTALL TYPE....:BUSWR IMPERV SURFACE: 0 sf
Remarks: Single family new residence — Path 1
Owner: FEES
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 2200.00 DRA 12/08/97 97- 301527
TIGARD OR 97223 INSP $ 35.00 DRA 12/08/97 97- 301527
Phone #:
Contractor: - - - - --
OWNER
Phone #: $ 2235.00 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 questions to OUNC by calling (503)246 -1987.
Issued b-: .64 • Permittee Signature: _ArAlgiCt./C
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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