Permit _ .i
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CITYOFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION
13125 SW Hall Blvd. Tigard,' Oregon 97223.8199 (503) 839 -4171 PERMIT
PERMIT # SWR94 -0402
639 -4171 DATE ISSUED: 12/13/94
PARCEL: 2S114A0 -WE033
SITE ADDRESS...: 08958 SW WAVERLY DR
SUBDIVISION....: WAVERLY ESTATES ZONING: R -12
BLOCK LOT .033;
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 -- -- - - --
ALDEN HEGLUND type amount by date recpt
8655 SE KING RD PRMT $ 2200.00 JF 12/13/94 -
INSP $ 35.00 JF 12/13/94 -
PORTLAND OR 97266
Phone #: 786-2932
Contract or: - - - - - --
CONTRACTOR NOT ON FILE
Phone #: V $ 2235.00 TOTAL
Reg #t...
` REQU I RED I NSPECT IONS -------
This Applicant agrees to cooply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency.' The peroit expires 180 days fro°
the date issued. The total aoount paid will be forfeited if the
per ®it expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the oeasureoent _
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given, the installer shall prospect 3. feet in all directions fro°
the distance given. If not so located, the installer shall purchase ,
a °Tap and Side Sewer' Peroit and the Agency will install a lateral. .
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P e r m i t t e e Signature: /�^rwc� -- - -- — -- -
Issued B y: _ _ - -
a ll for inspect ion, -, 639-4175 '
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