Permit CITY OF T SEWER CONNECTION
i A v ,. ;. \ DEVELOPMENT SERVICES PERMIT
�1f �'j PERMIT I T # • SWR96 -0437
'= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 1 2/ 03 / 96
PARCEL: 2S104BA -11400
SITE ADDRESS...: 13565 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK • LOT -144
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 1
Owner: FEES
DON MORISSETTE HOMES type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 DRA 12/03/96 96- 287181
INSP $ 35.00 DRA 12/03/96 96- 287181
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 Inspect ion
of the Unified Sewage Agency. The permit expires 188 days from
the date issued. The total mount 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 •easure.ent
given, the installer shall prospect 3 feet in all directions fron
the distance given. If not so located, the installer shall purchase
a 'Tap and Side Sewer° Permit and the Agency will install a lateral.
Permitt • e Signa' ure: AL l 4.h AkJ _
Issued :y: com4
Call for inspection — 639 -4175