Permit . i
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s itaE C7tvNNLC; IOi:' '
CI TV OF T I GARD . -. . ,_ . t� YI I l
. - .PERIIII T #•..: a ..... . SWR9,3 0219
COMMUNITY DEVELOPMENT DEPARTMENT
131$5 SW Hall Blvd: Tigard, Oregon 9722348199 839,4171 r . ; ,, -,_ _ • i tom r ;• f' 1 DATE 1.6SUEi1. 06/Gli 93
S I i E ADDRESS.... 12550 SW, 134TH: AVE .' PARCEL g 2311r..14AC:= 'll• :E' 700
iUi3DIV:Si:ON. „ -... NYiORN'IM .HILL .8 ' • ZOi'4INSi R-25 .
3LOCK. .. , _ .. •LOT o........ ... .. -: 171 • ' . .
•I E :N: iNT i■AME.
USA 'NO... ... . a. FUTURE UNITS.. - . •
C_AS:3 OF WORK'... ; NEW DWELLING UNITS. , g 1 • .. _ -
TYPE .OF USE ^ SF NO OF BUIL.D'INUS o f . . • • .. • ' - .
ISIS T Ai,L TYPE.... , I;tJSWR .. • - - . , , I MPER V SURFACE' . a s. f. .. .
Re lzr ks - PATH I '
•
.0, -- - - - . - -. -- L .
- ltiiESTDAL C' T a i . by 'ate • rep : . - •
n,� r S a ' . PL - 1 = ._
=i O •y- 171
o , .- , .,an! � F.gTri �L RI i I � c1�QJ...�[ Ji-f fit; /�:1l9,°.
. INSP $ 35. 0 JHi 06/2i/93 • --
PORTLAND OR' �l lc
1
Cont r�act or'a -------- - - - -•- -- - •- - - - - -•- . , - . .
CC ROCTOR NOT ON t ILE 1
•
. r:•i C,T1 e 'rr o . •• , S 2.t u5� i[7JZ7 TOTAL .
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- .- ..- -. -_ -, RLQUI RED' INSPECT IONS - •-• -• -•-
1 :is- pp!lcant agrees to to:piy with all the rules and r:oular1ons Sewer Inspeci:.ion __
r
- 111 tit U if i ed SEEZI1E plteicy: The per it expires 18; days frac _ ' ___ .. • •
it e. date issted. • The total acount paid will he forfeited if the ,
'pe:r�It ,ei:pires Tne Agency •does not guarantee the accuracy of the • •. .
site se -rr • laterals.. if the 'sewer is- not located at the neasurrecert ' _. _
Eiven, the installer shall prospect 3 feet in all 'directions fron - _ •
•
) 6:Ie•..distance. given. If. not so iocatec. tie- installer Shall Purchase • • .
a • Ta.p''anii.Side'Seler` 0eroit e :,s the Agency w.ii 'nstali D ' lateral. __ 'I ,
Pe :' :Ili 4'i-;ee Signaicur'e s _ ' _. \ . - -
' Call for inspection - 639- -4175 • • .
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