Permit - -- r.r. it C'1 r %k141r •T'T r:h,
PERMIT
CITY OF T I GARD DATE ISSUED: .
SSUED 0.10/01196 96-0462
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 25 104CA -01 900
SITE ADD RESS... a 13739 SW LAUREN LN
SUBDIVISION....; HILLSHIRE ZONING: R -7 PD
BLOCK........... LOT .............:019
TENANT NAME.....:
USA NO........... FIXTURE UNITE... a 0
CLASS OF WORK... :NEW DWELLING UNITS..: 1
TYPE OF USE..... :SF NO OF BUILDINGS: 1
INSTALL TYPE....: BUSWR IMPERV SURFACE: 0 sf
Remarks: Path 1
Owner: — —. •— - -- FEES - -- - - -- --
ENANOIL LEASE! type amount by date recpt
11349 SW 135TH ST PRi1T $ 2200.00 8 10/01/96 96- 284580
INSP $ 35.000 B 10/01/96 96.284560
TIGARD OR 97223
Phone 14: 579 -4092 .
Contract o r' a '-- —
CONTRACTOR NOT ON FILE
Phone *'sa $ 2235.00 TOTAL ,
Reg fin .. -
-- REQUIRED INSPECTIONS
This Applicant agrees to comply with aid 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. _,_ _ — �__
P e r m i t t e e Sir let r.A r e o CA- Oc_.C.P.2ge ,•�, 7 .. ..._...._._.._ _ _._.- __
15,1 Issued By: .11/' (�� — __ __ _ — __ ._ _ __ _ _ _ .
• Call for inspection — 639-4175