Permit , . CITY OF T SEWER CONNECTION
w,t -,� DEVELOPMENT SERVICES PERMIT
�I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT S SWR97 -0009
DATE ISSUED: 01/27/97
PARCEL: 2S104BA -15400
SITE ADDRESS...: 13546 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK • LOT °184
TENANT NAME
USA NO • - FIXTURE UNITS...: 0
CLASS OF WORK....: NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 1
INSTALL TYPE °BUSWR IMPERV SURFACE: 0 sf
Remarks: Single family new residence PATH I
Owner: — - - - - - -- FEES - - - --
DON MORISSETTE HOMES,_ . , ., type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 JSD 01/27/97 97- 289507
INSP $ 35.00 JSD 01/27/97 97- 289507
LAKE OSWEGO OR 97035
Phone #: 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 •of. the .
side sewer laterals. If the sewer is not: located at theLmeasurement
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. •
Permittee Signat ., � , �
Issued By- —��—
Jr _,,, Call for inspection.— 639 -41.75
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