Permit SEWER CONNECTION
CITY OF T PERMIT #PERMIT • SWR96 -0385
' COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/21/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S110DB -00200
SITE ADDRESS...: 15191 SW ROYALTY PKWY #K
SUBDIVISION • WILLOWBROOK FARM /ARBOR HEIGHTS ZONING: R -25 •
BLOCK • LOT •8
TENANT NAME 'ARBOR HEIGHTS
USA NO • FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 24
TYPE OF USE •MF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: BLDG K, 1 OF 14 MF UNITS
24 UNITS
Owner: FEES
SECURITY CAPITAL PACIFIC TRUST type amount by date recpt
SUITE 201 PRMT $ 52800.00 JMH 08/21/96 96- 283125
330 112TH AVE. , NE
BELLEVUE WA 98004
Phone #: 206- 451 -9292
Contractor:
DONALD M DRAKE CO
1740 NW FLANDERS ST
PORTLAND OR 97209
Phone #: 620 -0868 $ 52800.00 TOTAL
Reg #..: 084045
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 ill a la ral.
Permittee Signature: / ._
Issued By: - :.,;� , e . d t✓
Call for inspection — 639 -4175
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