Permit CELJE Ft CONNECT I ON
PERMIT
C o I F T I G ARD
DATE PERMIT
09/1 3/966 -0 434
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 8394171 PARCEL; 2S 104BA -10500
SITE ADDRESS...: 13689 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO. 3 ZONING: R -12 PD
BLOCK • LOT -135
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 $ 2`00.00 JDA 09/13/96 96- 283940
INSP $ 35.00 JDA 09/13/96 96- 283940
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg L. .
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 t relent _
given, the installer shall prospect 3 feet in all , rections 'rou
the distance given. If not so located, the in er shall .,
a "Tap and Side Sewer" Permit and t.- Ages 1 i lateral. '_
—
Permittee Signature:
Issued By: a — _ —
Call for inspection — 639 -4175
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