Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION
1,3125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERMIT
PERMIT 4S°°° °. ° °: SWR94 -041c
639 -4171 DATE ISSUED: 12120/94
PARCEL: 16125CD- 07200
SITE ADDRESS— °: 097.34 SW LANDAU PL
SUBDIVISION LANDAU WOODS ZONING: R -4
BLOCK— ° ° °° °° LOT. °. ° ° ° ° ° ° ° °° °:009
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 --
MICHAEL CHURCH HOMES INC type amount by date recpt
7440 SW 35TH PRMT $ 2200 °00 JF 12/20/94 -
INSP $ 35 °00 JF 12/20/94 -
PORTLAND OR 97219
Phone #: 293 -2109
Contractor: -- - - --
CONTRACTOR NOT ON FILE
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Phone #: $ 2235 °00 TOTAL
Reg 4° .
. REQUIRED INSPECTIONS -
This Applicant agrees to cooply with all the rules and regulations Sewer Inspect ion
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 insta all purchase
a 'Tap and Side Sewer' permit and the Agency tali a lateral.
P e r m i t t e e Signature: _
Issued By _ •__ _ — � ���
Call for inspection -•• 639 -4175
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