Permit ,
CITY TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2001 -00017
IP J , DEVELOPMENT SERVICES DATE ISSUED: 2/20/01
13125 SW Hall Blvd., Tigard, O 97223 (503) 639 -4171
SITE ADDRESS; 15299 SW REGENT TERR PARCEL: 2S111 DA -10800
SUBDIVISION: APPLEWOOD PARK NO. 3 - ZONING: R -7
BLOCK: LOT: 101 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF - NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new single family residence.
Owner:
FEES
LEGEND HOMES
12755 SW 69TH AVENUE #100 Type By Date Amount Receipt
PORTLAND, OR 97224 PRMT CTR 2/20/01 $2,300.00 27200100000
INSP CTR 2/20/01 $35.00 27200100000
•
Phone: 503 - 620 -8080 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: _ZZ9/-67-LJ-1--- ,
P Signatu ?t /i,` „ 7
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the busi ess day