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Permit ^ • CITY OF TI GARD WER CONNECTION PERMIT ,r DEVELOPMENT SERVICES Q R l G I N 4,L ERMIT #: SWR1999 -00264 ' 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 ISSUED: 02/15/2000 SITE ADDRESS; 12208 SW SWEENEY PL PARCEL: 2S103A6 -05300 SUBDIVISION: WALNUT GLEN ZONING: R -4.5 BLOCK: LOT: 011 JURISDICTION: TIG TENANT NAME: WALNUT GLEN 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 for new SF. Owner: FEES RIVERSIDE HOMES Type By Date Amount Receipt 15455 NW GREENBRIER PKWY #140 BEAVERTON, OR 97006 PRMT GEO 02/15/200C $2,300.00 00- 321710 INSP GEO 02/15/200C $35.00 00- 321710 Phone: 645 -0986 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection 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 • ales oft - -e r -s or direct questions to OUNC by calling (503) 246 -1987. � / Issued by: �i � Permittee Signature: 1 45 / 7 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day