Permit i
CITY OF TI G A R D SEWER CONNECTION
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, DEVELOPMENT SERVICES PERMIT
91i I ° PERMIT # • SWR97 -0021
;'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/03/97
PARCEL: 2S104BA -16100
SITE ADDRESS.. , : 13696 SW L I DF_N DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK........... LOT .............:191
TENANT NAME -DON MORISSETTE HOMES
LISA 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 ROAD PRMT $ 2200.00 DRA 03/03/97 97- 291104
INSP $ 35.01 DRA 03/03/97 97- 291104
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contractor: -- - - - - -- ------ • - - -•- -- --
CONTRACTOR NOT ON FILE
Phone #: `•r 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 amount paid will he 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 Agency will install a lateral. _
Permittee 1 .zture: _.. A k I ► A 1!& L
Issued By ' ,A. A I ,�
Call for inspection — 639 -4175