Permit CITY TIGARD SEWER CONNECTION PERMIT
ter, DEVELOPMENT SERVICES PERMIT #: SWR2001 00034
'•I I-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/6/01
SITE ADDRESS; 10610 SW WALNUT ST PARCEL: 2S1026C -02006
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R -4.5
BLOCK: LOT: 024 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 to connect existing house to newly installed sewer lateral. Reimbursement
District #14 fee of $8,000.00 was paid in addition to connection fee and inspection fee.
Owner:
FEES
EDWARDS, ANNE D + HARVEY 0
10610 SW WALNUT ST Type By Date Amount Receipt
TIGARD, OR 97223 INSP CTR 2/6/01 $35.00 27200100000
PRMT CTR 2/6/01 $2,300.00 27200100000
Phone: 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 Ore o Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You m obtain cop of these ru =- or direct questions to OUNC by calling (503) 246 -1987.
Issu by: , 2111/1 , Permittee Signature: ii ,
Call (5: • 9 by 7:00 P.M. for an inspection needed the next business day
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February 6, 2001 � r mrv .riq , lipll`'�li l �
CITY OF TIGARD
OREGON
Anne D Edwards
10610 SW Walnut St
Tigard OR 97223
Dear Mrs. Edwards,
Enclosed is a copy of your sewer connection permit and a receipt for the sewer permit fee
and the reimbursement district fee.
Please note that your plumbing contractor still needs to obtain a plumbing permit for the
sewer line work from the house to the sewer lateral.
If you have any questions please give us a call at 503- 639 -4171, extension 304.
Sincerely,
I (2 4 0 62_41&4 11 t
Debbie Adamski
Building Services Technician
Enclosures
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
„ 0 C 2 4 9.00 i -c003(/
August 24, 2000 ��' +
_<e/ CITY OF 11G
1- (e ��`' OREGON
Edwards Anne D & Harvey 0 G „6”.
10610 SW Walnut St
Tigard OR 97223 b �.1 2 � P te_ - \o►�
J � d `q tr f �
� ai t - 1
C C NOTICE
of
Sewer Service Availability
On July 13, 1999, the Tigard City Council approved Resolution 99 -53 establishing
Sanitary Sewer District No. 14 (SW Walnut Street and Tiedeman Avenue). A copy of
the resolution and the final City Engineer's Report are enclosed. Construction of the
sewer has been completed and service connections are now available.
Connection to the line is not required and no payment is currently due. Connection to
the sewer will require payment of a reimbursement fee. This fee for your lot is currently
$12,126 and will be increased annually by $685.28. For connections completed by
August 23, 2001, the fee will be reduced to $8,000.
In addition to this fee, the owner would also be required to pay a connection fee,
currently $2,335, at the time of connection to the sewer. In addition, property owners
are responsible for disconnecting their existing septic system according to Washington
County rules and for any other modifications necessary to connect to the public sewer.
If you wish to connect to the sewer, additional information is available from
Development Services at the City Hall front counter or by telephoning 639 -4171,
extension 304. oa
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
CITY.-OF TIGARD BUILDING INSPECTION DIVISION
• 24 -tii,ur Inspection Line: 639 -4175 Business Line: 6 9-4171 /
� vi
Date Requested „.1.- 8 AM PM BLD
Location ( ( .5w w h 4 S Suite �/ ME
Contact Person Ph 937 52-
Contractor Ph — OOO_N
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Slab Crawl Drain Inspection Notes: . �� �� SGN
Post & Beam SIT
Ext Sheath /Shear
Int Sheath /Shear C j a - C<-‘2A- raming /)
Insulation J p n �
Drywall Nailing 17.12 - p
Firewall / jt Jae/11---
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
taP*
Post & Beam
Under Slab
Top Out
Water Service 4 -� �l -$-' ,,, ^
) "" �itl v ✓ L4 v
ain Drains
Fin,.
° PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
In 4,"
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk (( (e other Date 0 Inspector Ex
Final
1
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
, I
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..',.- invoice
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GRIFF SEPTIC SERVICE, INC.
Name/' ip A l ( - 3 R c=_. . . ' _ ' A' Date 5•• — 7 — 0 (
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Address k) iT' . C) SO A...)A1.-A)(CTS 1 Phone ''‘-- ..) / —
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City I /2/4 0 .__ : Vial On Acct.
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State ( 7 ) g. • - Zip Code AA--y
Price Amount
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NOT RESPONSIBLE FOR DAMAGES PAST CURB LINE OR LANDSCAPING
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A service charge of 1.5% per month will be charged on all past due accounts. Total: ii:,.... . .:..., r ) • •::„.._: )
Customer is r Sponsible for attorney's fees in pursuit of payment. --
A fee of $15. 0,Will be charged on all returned checks.
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By -- - i-• :17 • ------ ,_ ........_.....
Customer Signature
T You P.O. BOX 1244. • Canby, OR 97013
DEQ# 36912
(503) 263-2087 or (503) 632-6138 CCB# 104320
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