Permit CI1'i OF TIGARD
SEWER CONNECTION
PERMIT # PERMYT SWR95 -0052
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 02/02/95
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 839 -4171
PARCEL: 1S134DB —TE007
SITE ADDRESS...: 11102 SW TORLAND ST
SUBDIVISION....: TORLAND ESTATES ZONING: R -4.5
BLOCK........... LOT. — — . ...... . g 007
TENANT NAME.....:
US-1 NO...... , .... FIXTURE UNITS... .
CLASS OF WORK... :NEW DWELLING UNITS.. 21
TYPE OF USE. .... : SF NO. OF BUILDINGS :1
INSTALL TYPE....:BUSWR IMP'ERV SURFACE.. g a sf
Remarks: PATH I
Owner: -- - -- FEES - - - -•
RENAISSANCE DEVELOPMENT type amount by date recpt
1672 SW WILLATTE FALLS DR PRMT $ 2200.00 JF 02/02/95 —
INSP $ 35.00 JF 02/02/95 —
WEST LINN OR
Phone *g. 557 -8000
Contract or:
CONTRACTOR NOT ON FILE
Phone ite $ 2235.00 TOTAL
Reg #.. L.
REQUIRED INSPECTIONS
This Applicant agrees to cooply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The peroit expires IN days froo —
the date issued. The total aoount paid will be forfeited if the
peroit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is net located at the oeasurecent
given, the installer shall prospect 3 feet in all directions froo
the distance given. If not so located, the installer shall purchase
a °Tap and Side Sewer" Peroit and the Agency will•,stall a lateral.
Permittee Signature: __ - - -- — —
Issued Bye _ .
Call for inspection — 639 -4175 •
qs— olLet 33 2—