Permit 3 0 - CITY OF TI GAR ! SEWER CONNECTION PERMIT
,r
- ili& DEVELOPMENT SERVIC ' � GINAL PERMIT #: SWR2000 -00004
E ISSUED: 01 /18/2000
i 13125 SW Hall Blvd., Tigard, OR 97223 (5.3) 639 -4171
SITE ADDRESS; 08950 SW PIPPEN LN PARCEL: 2S111 DA -15400
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 147 JURISDICTION: TIG
TENANT NAME: LEGEND HOMES
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR • IMPERV SURFACE:
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Remarks: New SF - sewer connection
Owner: FEES
LEGEND HOMES
6900 SW HAINES ST Type By Date Amount Receipt
TIGARD, OR 97223 PRMT GEO 01/18/200C $2,300.00 00- 321186
INSP GEO 01/18/200C $35.00 00- 321186
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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Sewer Inspection
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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 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain of • -se rule 'r direct questions to OUNC by calling (503) 246 -1987.
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Issued b • la P ermittee Signature: ��
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the ,'-xt busine— ay