Permit CITY O F TIGARD SEWER CONNECTION
.�y DEVELOPMENT SERVICES SERV I PERMIT # PERMIT v e SWR97-0095
Tigard, ( )
DATE ISSUED: 04/16/97
PARCEL: 2S103BD —HG035
SITE ADDRESS... :125W SW 115TH AVE
SUBDIVISION .HUNTER'S GLEN ZONING: R -4.5 PD
BLOCK LOT •035 JURISDICTION:
TENANT NAME -LEGEND HOMES
USA NO FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 1
INSTALL TYPE •LTPSWR IMPERV SURFACE: 0 sf
Remarks: New'SFD
Owner: FEES
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 2200.00 DRA 04/16/97 97- 29331.2
TIGARD OR 97223 INSP $ 35.00 DRA 04/16/97 97- 293312
Phone #:
Contract or:
OWNER •
•
Phone #: $ 2235.00 TOTAL
Reg #...
REQUIRED INSPECTIONS
This Applicant agrees to coeply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 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 install- - al pu- -'e
a °Tap and Side Sewer' Permit and the Age- y /� tal. 4 al.
%%% ..__
Permitt:e Signa.ure: d/ /,.
Issued B , . . ii'!l f�J1 I, •� -
Call for inspection — 639 -4175