Permit 1 CWCr[ 1.. 1 iV14
• PERMIT
IlY OF T I GARD DATE 04/29/96 -0175
COMMUNITY DEVELOPMENT DE PARCEL: 2S 104BA- 08200
SI TE 311, DRES SS;d: Tigard, 1 8818 7 SW 8 L I DhIV eD90171
SUBDIVISION ° CASTLE HILL #2 ZONING: R -25 PD
BLOCK • LOT •117
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 I
Owner: FEES
MORISSETTE HOMES type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 JDA 04/25/96 96- 278538
SUITE #151 INSP $ 35.00 JDA 04/25/96 96- 278538
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 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
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 Si• nature:
Issued By: •e
/ Call for inspection — 639 -4175