Permit C I TV OF TIGARD S[WL7' CONNECTION
COMMUNITY DEVELOPMENT DEPARl[MENT r
1m8mW Hall Blvd. n�m�.Oregon m72o°w1en (6� �
nm-4171 PERMIT 4 ^ CWR�5'0154
&C.°. -4171 DATE ISSUED: 05/09/7:5
138 3 PARCEL: 2S104BA-1218900 •
SITE ADDRESS... DR
SUBDIVISION ^ CASTLE FILL #2 ZONING: R-25 PD
BLOCK : LOT :l24
__________________________________ _ _____________
TEN.:1Y‘4T NAME
USA NC ` FIXTURE UNITS...: •
°LAOS OF WORK. . . ; NEW DWELLING UNITS. . :1
— YrE OF USE 3F NO. OF DUILDINGS:1
INSTALL TYPE ^BUCW IMP ER%; SURFACE.. f
Remarks: PATH I
C�nar� --'--------------- ---- — FEES — '--
C]!`: ^« r. type amount by date ■•ecr.t
5000 SW MEADOWS RD PRMT $ 2200.N0 B 695/09/95 — 73U T[ 1E1 INSP $ 35.00 B 05 /121.
LAKE OSWEGO OR 97035
re # E
CoTt;ractor: — -------- ----------
CONTRACTOR NOT ON FILE
ne $ 2235.21@ TOTA
Reg #..;
------- REQUIRED INSPECTIONS ----
Applica7t agrees to coap:y with all the rules and regulations Sewer Inspect ion _
of the Unified [ewa§s Agency. The wait expires 180 days from
the date is4od. The total amount paid will be forfeited if the _
perait expires. The Agency dces not guarantee the accuracy of the _______________
side sewer laterals. If the sewer is not located at the measurement ________
given, the insta:ler shall prospect 3 feet in all directions frog .__
the distance given. If not so located, the installer sha 1 ^rc _ _______
"-e- and Side 5ew�~" Pormit a�� th A ll a 1 ral
, ,^ - , . - -___
Pe.`ui1;tee Siorat �� / __ _
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\� �all for inspection — 639-4175
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