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Permit VOID 0,9 0_5 lik C ITY OF TIGARD SEWER CONNECTION PERMIT 1k DEVELOPMENT SERVICES PERMIT #: SWR2005 -00005 c � l I I 131 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 D ATE ISSUED: 2/16/2005 PARCEL: 2S1 09 DA -08600 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST ZONING: SUBDIVISION: SUMMIT RIDGE LOT: 080 JURISDICTION URB Project Description: New SF sewer connection. TENANT NAME: CWS NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1.0 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Owner: FEES DON MORISSETTE COMMUNITES LLC 4230 GALEWOOD ST # 100 Description Date Amount LAKE OSWEGO, OR 97035 [SWUSA] Swr Connection Fee 2/16/2005 $2,500.00 [SWINSP] Sewer Inspection Fee 2/16/2005 $35.00 Phone: " 503- 387 -7538 Total $2,535.00 Contractor: REQUIRED ITEMS AND REPORTS Phone: Reg #: 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" 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued by: Permittee Signature: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. C ITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT #: SWR2005 -00005 +L ..� II DATE ISSUED: 2/16/2005 13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS; 12970 SW SUMMIT RIDGE ST PARCEL: 2S109DA -SR080 SUBDIVISION: SUMMIT RIDGE ZONING: R - BLOCK: LOT: 080 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: New SF sewer connection. Owner: FEES DON MORISSETTE COMMUNITES LLC Description Date Amount 4230 GALEWOOD ST # 100 LAKE OSWEGO, OR 97035 [SWUSA] Swr Connectic 2/16/2005 $2,500.00 [SWUSA] Swr Connectic 2/16/2005 $0.00 Phone: 503- 387 -7538 [SWINSP] Sewer Inspect 2/16/2005 $35.00 [ SWINSP] Sewer Inspeci 2/16/2005 $0.00 Total $2,535.00 Contractor: REQUIRED ITEMS AND REPORTS Phone: Reg #: LIC 35533 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" 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 -0100. You may obtain of these rules or direct questions to OUNC by calling (503) 246 -6699. Issued by: d e 6 r/trliti Permittee Signature: y Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day