Permit CITY OF TIGARD
/�,,, DEVELOPMENT SERVICES PERMIT
A SEWER CONNECTION
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.: - A L 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 639 -4171 PERMIT # • SW R98 -0176
DATE ISSUED: 08/18/98
PARCEL: 2S1O4DB -04300
SITE ADDRESS...:13 10 SW ROCKINGHAM DR
SUBDIVISION °AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT °043 JURISDICTION: TIG
TENANT NAME ° DALTON CONSTRUCTION INC
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
DALTON CONSTRUCTION INC type amount by date recpt
8465 SW HEMLOCK STREET PRMT $ 2300.00 GEO 08/18/98 98- 308386
SUITE A INSP $ 35.00 GEO 08/18/98 98- 308386
TIGARD OR 97223
Phone #:
Contractor:
DALTON CONSTRUCTION INC
8465 SW HEMLOCK ST
SUITE A
TIGARD OR 97223 -•
Phone #: 452 -0969 $ 2335.00 TOTAL
Reg #..: 000677
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 direct questions to I. -y calling (503)246 -1987.
I ssued by° ��� %.,i %1 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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