Permit CITY OF TIGARD
� DEVELOPMENT SERVICES SEWER CONNECTION
— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT
PERMIT # • SWR98 -0022
DATE ISSUED: 02/17/98.
PARCEL: 2S1O4DB -03500
SITE ADDRESS...: 13126 SW WELLINGTON PL
SUBDIVISION - AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT •035 JURISDICTION: TIG
•
TENANT NAME
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: Single family detached — Path 1
Owner: FEES
DALTON CONSTRUCTION type amount by date recpt
8465A SW HEMLOCK ST PRMT $ 2200.00 JSD 02/17/98 98- 303319
TIGARD OR 97223 INSP $ 35.00 JSD 02/17/98 98- 303319
Phone #:
Contractor:
OWNER
Phone #: $ 2235.00 TOTAL
Reg L. :
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
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 ay obtain copies of
these rules or direct questions to OIRIC calling (503)246 -1987.
Issued by: Permittee Signature: -L: Lt.. 4
411■, /
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Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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