Permit SEWE CONNECTION
CITY OF TIGI4RD PERMIT c
F�ERI�IIT # SWR95 -0389
OMMUNI DEVELOPMENT kli NT DATE ISSUED: 1 /06/9
(.13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 251 04DC -08 7 00
SITE ADDRESS.. ° : 13285 SW WOODSH I RE LN
SUBDIVISION MORNINGSTAR ZONING: R -4.5 PD
BLOCK LOT °024
TENANT NAME
USA NO FIXTURE UNITS...:
CLASS OF WORT; ° ° ° : NEW DWELLING UNITS-21
TYPE OF USE .SF NO. OF BUILDINGS :1
INSTALL TYPE °BIJSWR IMPERV SURFACE—: : :sf
Remarks: PATH I
Owner: - - - -- - - - FEES - - --
BARRY MANSOUR type amount by date recpt
11681 SW TEAL BLVD # B PRMT $ 2200.00 JDA 10/06/95 95- 271397
INSP $ 45.00 JDA 10/06/95 95- 271397
BEAVERTON OR 97007
Phone #: 579 -0911
Contractor
CONTRACTOR NOT ON FILE
__________
Phone #: $ 2235° 00 TOTAL
Reg 4i..
REQUIRED INSPECTIONS
This Applicant agrees to coaply 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 oeasurement
________
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 install a lateral.
Permittee Signature: k, I% *A
Issued By: ft. VP, �
Call for inspection -. 639 -4175
� 5 _ c)--7139