Permit 1
SEWER CONNECTION
CITY OF TIGARD PERMIT #PERMIT SWR95_0247
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/05/95
13125 SW Hall Blvd. Tigard, Oregon 97223•8199 (503) 639 -4171
PARCEL: 1512600 -01107
SITE ADDRESS... 09633 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING° C -G
BLOCK...... ° .. ° . LOT
TENANT NAME -COOL TEMPTATIONS
USA NO FIXTURE UNITS...e24
CLASS OF WORK...:TEN DWELLING UNITS..:2
TYPE OF USE °COM NO. OF BUILDINGS:
INSTALL TYPE °BUSWR IMPERV SURFACE..° osf
Remarks: food court tenant
Owner: ----- - - - -- - FEES - - -- - - --
COOL TEMPTATIONS type amount by date recpt
9633 SW WASHINGTON SO. RD. PRMT $ 4400.00 JD 07/05/95 95- 267562
TIGARD OR
Phone #:
Contractor:
CONTRACTOR NOT ON FILE
Phone #2 $ 4400. 00 TOTAL
Reg #...
- -- -- t.0 RED NSPECT I ONS
This Applicant agrees to coaply with all the rules and regulations ti.r
of the Unified Sewage Agency. The perait expires 180 days freo - 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 not located at the oeasureaent
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° Percit and the Agency will install a lateral.
Permittee Sign i 1 u'����/ - - -- - —
Issued By: / -- /\ C -- - - --
Call for inspection -• 639-4175
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