Permit bEWbK LUNNLL I lUN
an OF TIGA F.... .. SWR95 -0270
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PERMIT #.....:
COMMUNITY DEVELOPMENT DEP DATE ISSUED: 07/20/95
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL : 25 104BA -09100
SITE ADDRESS... n 13895 SW L I DEN DR
SUBDIVISION • CASTLE HILL #2 ZONING: R -12 PD
BLOCK • LOT •126
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 SW 07/20/95 —
SUITE 151 INSP $ 35.00 SW 07/20/95 —
LAKE OSWEGO OR 97035
Phone #: 620-7538
Contract or:
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 t-- dient
given, the installer shall prospect 3 feet in a - "` � •. _
the distance given. If not so located, tho ,nsta'ler shall 1jur :se
a "Tap and Side Sewer" permit and the tency w'tl inst -'. a :- eral.
Permittee Sionature: /
Issued By: 5011 — —
Call for inspection — 639 -4175
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