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Permit CITY OF TIGARD '° CO1VIMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERM I T PERMIT # • SWR96 -0211 �/ � ,,�`r Q 7 DATE ISSUED: 08/02/96 50101 -0 J � 7 "j ' " 7 14* RCEL : 1 S 133DN-FC019 SITE ADDRESS...: 13219 SW SUMMERWOOD DR SUBDIVISION • g t ZONING: R -25 BLOCK LOT •019 TENANT NAME °BOWEN REAL ESTATE TO SELL USA NO • FIXTURE UNITS...: 0 CLASS OF WORK...:NEW DWELLING UNITS..: S TYPE OF USE °SF NO. OF BUILDINGS: 1 INSTALL TYPE °BUSWR IMPERV SURFACE: 0 sf Remarks: SEWER PERMIT FOR 5 UNITS IN BUILDING #4 OR 5 DUBS Owner: --- ---- - - - - -- -- - - --- FEES MCM ARCHITECTS type amount by date recpt 1022 SW SALMON SUITE 350 PRMT $ 11000.00 JDA 08/02/96 96- 282471 INSP $ 35. 00 JDA 08/02/96 96- 282471 PORTLAND OR 97205 Phone #: 222-5757 Contractor: -- CONTRACTOR NOT ON FILE Phone #: $ 1 1035. 00 TOTAL Reg 4.. . REQUIRED INSPECTIONS -- - - - - -- This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 150 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 directi , r _ the distance given. If not so located, the 'I -.11- s =/ purcha-e _ _ a "Tap and Side Sewer" Permit and the y wil in- a late A ; J - 1= 'ermittee Signature: i •''�� _ _ � Issued B y: y - - - - ----_- Call for inspection - 639 -4175