Permit SEWER CONNECTION
CITY OF TIGARD
PERMIT . .
PERMIT #.. SWR96 -0433
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09 / 30 / 96
13126 SW Hem Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 25104BA -1 1300
SITE ADDRESS...: 13577 SW L I DEN DR
SUBDIVISION....: CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK LOT • 14.3
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 B 09/30/96 96- 284528
IN SP $ 35.00 B 09/30/96 96 -- 234523
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contractor: --
CONTRACTOR NOT ON FILE
Phone # : $ 2235. 00 TOTAL
Reg ##...
REQUI RED 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 the measurement
given, the installer shall prospect 3 feet in all directions from
t! distance given. If not so located, the installer shall purchase
a °Tap and Side Sewer° Permit and the Agency will install a lateral.
Permittee Si attire: ,,LAO ic/t 1 _
c
Issued By: Dr0.4 ��
Call for inspection — 639 -4175