Permit CITY OF T SEWER CONNECTION
% ± �- ��I�,iI • DEVELOPMENT SERVICES PERMIT #PERL�1ITv : SWR97-0100
Tigard, ( )
DATE ISSUED: 04/17/97
PARCEL: 25104CA -03000
SITE ADDRESS... :13552 SW LAUREN LN
' SUBDIVIS:ION....:HILLSHIRE ZONING: R -7 PD.
BLOCK.......... LOT ............. :030 JURISDICTION: TIG
TENANT NAME..... :NICOLAE GHITEA
USA NO FIXTURE UNITS...: 0
CLASS OF WORT',... :NEW DWELLING UNITS..: 1
TYPE OF USE '•'SF '" NO. OF BUILDINGS: 0
INSTALL TYPE •1_TP IMPERV SURFACE: 0 sf
Remarks: Path •1' .
Owner: • — ` FEES - ---
NICOLE GHITEA type amount by date recpt
5541 NW DEERFIELD WAY . PRMT $ 2200.00 DRA 04/17/97 97- 293460
PORTLAND OR 97229 INSP $ 35.00 DRA 04/17/97 97- 293460
Phone #
Contractor:
OWNER
Phone #: $ 2235.00 TOT-
Reg - #..'a . •
REQUIRED INSPECTIONS -----
This Applicant agrees to comply with all the rules and regulations Sewer . Inspection __ T
of the Unified-Sewage Agency. The permit expires 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.Elocated, the 'installer shall purchase — _ _
a 'Tap and,•Side Sewer "' Permit' and' the..Agency��wi^ll install a• lateral. ��
Permitt Si aturreo 1.8 � - em.tek--).... II „
Issued y: Cd6t___ _
Call far inspection — 639 -4175