Permit • CIT' OF TIG4RD SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT # • SWR94 -0353
13125 SW Hall Blvd. Tigard. Oregon 97223•(31%93 6p9 41 71 DATE ISSUED: 11/16/94
PARCEL: 2S104BA -08400
SITE ADDRESS...: 13762 SW LIDEN DR
SUBDIVISION • CASTLE HILL #2 ZONING: R -12 PD
BLOCK • LOT •119
TENANT NAME •
USA NO • FIXTURE UNITS...:
CLASS OF WORK...: NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS:1
INSTALL TYPE •BUSWR IMPERV SURFACE..: :sf
Remarks: PATH I
Owner: FEES -- - -- - --
DON MORISSETTE type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 KS 11/16/94 —
SUIT 151 INSP $ 35.00 KS 11/16/94 —
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 accur.• of the
side sewer laterals. If the sewer is not located at,4.- - �asurea= .
given, the installer shall prospect feet in - directions fr __
the distance given. If not so loca ed, the ' st, ler shall pus se
a "Tap and Side Sewer" Permit and t'. A cy w 11 inst . . ateral.
Permittee Signature: \• /`� _
• —
Issued By: /.
i
Call for inspection — 639 -4175
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