Permit CITY OF TIGARD
% c� DEVELOPMENT OR LOPMENT SERVICES SEWER PERMIT
13125 PERMIT # • SWR98 -0066
DATE ISSUED: 04/22/98
PARCEL: 1S135CD- 09600
SITE ADDRESS...:O9955 SW PIHAS CT
SUBDIVISION -JACOB COURT ZONING: R -12
BLOCK LOT •004 JURISDICTION: TIG
TENANT NAME • DAV IS, CHAD E.
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: Sewer connection for a new single family dwelling.
Owner: FEES
CHAD E DAVIS type amount by date recpt
PO BOX 794 PRMT $ 2200.O0 DLH 04/22/98 98- 305175
FOREST GROVE OR 97116 INSP $ 35.00 DLH 04/22/98 98- 305175
Phone #:
Contractor:
CHAD DAVIS
PO BOX 794
FOREST GROVE OR 97116
Phone #: 693 -6580 $ 2235.00 TOTAL
Reg #..: 000825
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 '.z1-0080. You may obtain copies of
these rules or direct questions to OJNC by calling 1503)246 -1987.
Issued by: Permittee Signature:
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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