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Permit . _ • , CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT ��~�~~~��" .°.~~n�o ~�m~nx�"��m~*� PERMIT #..... ~: SWR97-0015 13125 SN/Ma0BA�,�R�72�� 03 �3�4/7/ ^ Tigard, ' --/ DATE ISSUED: 01/31/97 PARCEL: 2S104CA-02800 SITE ADDRESS..~..,: .13515' E}W LAUREN .LN • - ' ' HILLSHIRE / ' ~ • ` • ZONING: R-7 PD BLQCK.. ..... ...: LOT— ..........:028 TENANT NAME ~J DREILING CONSTRUCTION USA NO. . � FIXTURE UNITS...: 0 CLASS OF WORK. ; .:NEW DWELLING UNITS.. : 1 TYPE OF ' NO. OF BUILDINGS: 1 . INSTALL TYPE'...:BUSWR IMPERV SURFACE: 0 sf Remarks:`Path^ 1^~ Owner: FEES J DREILING CONSTRUCTION type amount by date recpt 15100 SW PLEASANT VALLEY RD ,, 2200. 00 JMH 01/31/97 97-289757 INSP $ 35.00 JMH 01/31/97 97-289757 BEAVERTON OR 97007 Phoine%-#:A6277-9059'`t•. i Contractor: • C8NTRACT8R•NQTI,,8� • • . ___ Phone #: • $ 2235.00 TOTAL Reg #..: . •' '`. . REQUIRED: INSPECTIONS This Applicant-agrees-to-comply with all the rulesand•regulations ',' • Sewer: Inspection, of the Unified Sewage-Agency. The,pern@L expires ,U80;;days,fqott • .` ' - ` . Itthe datxoissuedm1,Tbe:tdtaf,apant/ ' • ' • ' permitoxpiney.-1111eAoeoppduosvnot,guara0teeAhaccunacy~pf�her^T� �� ~ • � "'� �' ' ^ ' • '• - si8n'sewmalatpra{aV sewpn ndt locatod,at4homoastiremont�,��"� ' . `'� ��'� ^ '`' ' ` given, the-installer' shal}' pros pact 3^teut ina[Lmdrectione • '+. __ the distance given. If oot'so'locatpd0he instaylor°lhall~pqrchase� a "Tap and Side Sewer" Permit and the^Aoency`will'install' ' --- Permittee Signature: . . „ Issued By: ~ ,~`� ~` �Y�� .'�' .�^�. �Cal'l, fo�_�ospect.ionr,' 63974175�`� • . • • ^ '