Permit Or
CITY OF T I G A R D SEWER CONNECTION
• PERMIT
^ .. iVi ;ii i DEVELOPMENT SERVICES PERMIT
01/21W97C— 410
PARCEL: 1S134AC -02400
SITE ADDRESS...: 13503 SW LIDEN DR
SUBDIVISION . • ZONING: R -4.5
BLOCK • LOT •
TENANT NAME.....:
USA NO • FIXTURE UNITS...: 0
CLASS OF WORT:...: NEW DWELLING UNITS..: 1
TYPE OF USE •SF . ,. NO. , OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Path I
Owner: FEES
DON MORISSETTE HOMES type amount by date recpt
50000 SW MEADOWS RED PRMT $ 2200.00 DRA 01/21/97 97- 289183
INSP $ 35.00 DRA 01/21/97 97- 289183
LAKE OSWEGO OR 97035
Phone #: 503 -620- 7538.
Contractor: --
CONTRACTOR NOT ON FILE
Phone #: $ 2235. 00 TOTAL
Reg #..•
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if•the
permit expires. The Agency does not guarantee the accuracy 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 t • '.ency will install a lateral.
Permittee ig _� ! �� L I,
Issued B A 4
Call for inspection — 639 -4175