12320 SW SUMMER CREST DRIVE 12320 SW .3UMMER CREST DRIVE
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Receipt #5675
SEWER PERMIT N: 21990
Unified Sewerage Agency
of Washington Coil qty CITY OF Tigard DATE _ 5/7/80
OWNER : Richard Torrance _ PHONE : 639-8457 _
OWNER ' S ADDRESS: 1.2320 SW Summerc:rest Drive
iYPF OF INSTALLA f 'ON:
E] BUILDING SEWER ❑ BUILDING SEWER AND .SIDE SEWER
TYPE OF OCCUPANCY:
❑ NEW STN,-,LF FAMILY [� COMMERCIAL
[XI EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. [] INDUSTRIAL_
FIXTURE UNITS DWELLING UNITS, 1 _
ADDRESS OF STRUCTURF : 12310 SW Summuzcrest Drive
PERMIT CONDITIONS: THE APP1ICANT AGREES TO COMPLY WITH ALL PULES AND
REGULATIONS OF THE UNIFIED :SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION ,
PLE,A`;F REFER TG THE PERMIT NUMBER. THIS APPLICATION EXP:r1ES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED ShOULD
EXPIRATION OCCUR .
FEES:
PERMIT FEE $ 25. PO
CONNECTION CHARGE 300. 00
SIDE SEWER INSTALLATION Fenny LiebErtz
ISSUED BY
OTHER
TOTAL $ 325. 00
rig V APPLICANT DATE
ABOVE CX E. SES';EA SEPViCt
GHk11E {rY'ILL 6EOtN FC II THIS SEWER PERMITPE1,11 T.
ADDRESS OF STRUCTURE — 12320 SW Summercrest QLive - _
TAX MAP TAX LOT S- r-r,�
-- _. S Y., i
LOT BLOCK — Or
-- ETW _ 5L7/60 � 0
AF'PROVFD BY �- DATE ISSUED BY — DATE TE
D . U . ' S = PFMARKS Septic tank to be pumped and filled With sand,
per State rods-.. !,n pipe (mir`Oirnum) required.
ALSO LEFm HFIGFiTS SEWER SURCHARGE OF $150. 00
J+
NV
Unified Sewerage Agency
of Washington County CITY OF _ DATE
OWNER : t 14-IL If / D A l� C_ 1= PHONE
OwriER ' S ADDRESS : .� � � .� C)
TYPE OF INS-TALLAT [ON :
❑ BUILDING SEWER ❑ BUILDING SEVER AND SIDE SEWER
TYPE OF OCCUPANCY :
❑ NEW S I NGI_E FAMILY ❑ COMMERCIAL
EXIST. (PRIOR TO 7- 1-70 ) ❑ MU'-T. RES. [] INDUSTRIAL
FIXTURE UNITS-- DWELLING UNITS
ADDRESS OF STRUC FURS : r,=� 1,
PERMIT CONDITIONSi THE APPLICANT AGREES 10 COMPLY WITH ALL RULES AND
REGJLATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR INSPECTIGrd ,
PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION EXPIRES IN ONC-
HU140RED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL 9E FORFEITED SHOULD
EXPIRATION OCCUR .
FEES :
PERMIT FEE s � d Obi •
CONtIECTION CHA;,GE
SIDE SEWER INSTALLIAT,pION
OTHER
'7!
ISSUED BY -.
TOTAL $ r'
��— APPLICANT DA�"E
SE-J"ER PERMIT
----- - Q
ADDRESS OF STRUCTURE •
TAX MAP _ TA: LOT
SYSTEM
L 0 T 3LOC K -- OF
APPROVED BY -- +_- DATET ISSUED BY -- DATE
D . U . ' S REMARKS 1 �tit� ' r