Permit SEWER CONNECTION
CITY OF TIGARD PERMIT
PERMIT #.......: SWR94 -0027
COMMUNITY DEVELOPMENT D6P7 1141gA1T DATE ISSUED: 02/17/94
13125,6W Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S104CA -10100
SITE ADDRESS...: 13721 SW JENNA CT
SUBDI VISION. °°.: HILLSHIRE ZONING: R -7 PD
BLOCK..... ..... ° LOT .............:101
'TENANT NAME °
USA NO.......... FIXTURE UNITS...:
CLASS OF WORK... :NEW DWELLING UNITS.. :1
TYPE OF USE °SF NO. OF BUILDINGS:1
INSTALL TYPE °BUSWR IMPERV SURFACE..: :sf
Remarks: PATH I
Owner: -- FEES
PAHLISCH HOMES INC type amount by date recpt
15100 SW KPLL PARKWAY PRMT $ 2200.00 JH 02/17/94 —
SUITE E INSP $ 35.00 JH 02/17/94 —
BEAVERTON OR 97006
Phone #: 643
Contract or:
CONTRACTOR NOT ON FILE
Phone # : $ 2235. 00 TOTAL
Reg L. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IN 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.
Permittee Signature %'h�..L �. �'Zi �... . 1�
Issued By:
6
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Call for inspection — 639 -4175
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