Permit CI TY OF TIGARD SEWER CONNECTION PERMIT
AA DEVELOPMENT- SERVICES PERMIT #: SWR2003 -00329
47:111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 9/30/03
SITE ADDRESS; 13825 SW SANDRIDGE DR PARCEL: 2S105DD -07500
SUBDIVISION: COSTIUC MLP2001 - 00005 ZONING: R -
BLOCK: LOT: 002 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached.
Owner:
FEES
D R HORTON INC Description Date Amount
4386 SW MACADAM AVE #102
PORTLAND, OR 97201 [SWUSA] Swr Connect 9/30/03 $2,400.00
[SWUSA] Swr Connect 9/30/03 $0.00
Phone: 503 222 - 4151 [SWINSP] Swr Inspect 9/30/03 $35.00
[SWINSP] Swr Inspect 9/30/03 $0.00
Contractor:
Total $2,435.00
Phone:
Reg #: •
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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" Perm
Issued by: / Permittee Signature: l�� . - ",/
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day