Permit CITY OF TIGARD SEWER CONNECTION
PERMIT
• COMMUNITY DEVELOPMENT DEPARTMENT PERMIT # • SWR96 -0219
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 639 -4171 DATE ISSUED: 05/20/96
PARCEL: 2S104BA —C3182
SITE ADDRESS...: 13522 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK • LOT •182
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: PATH I
Owner: FEES - - - -•
DON MORISSETTE HOMES INC type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 JMH 05/20/96 96- 279616
SUITE # 151 INSP $ 35.00 JMH 05/20/96 96 -279616
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contract or:
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 1= rp,3/
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 Age cy will install a lateral.
Permittee Signature:
Issued By: I I // ^ #1
Call for inspection — 639 -4175