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7430 SW CHERRY DRIVE r- m s i 1 7430 8W CHERRY DRIVE ,� SEWER PERMIT' �� Uf Unified Sewerage Agency CITY OF , Of Washington County DATE _ OWNER ©1*e�/0A ♦ rY PHONE OWNER'S A D C R E SS, ? S <G, C y,Gr�/P l/ S�:_ .�•--�iril'�1 _ TYPE OF INSTALLATION, ® BUILDING SEWER ❑ LINE TAP AND BUILDING SEWER ❑ LINE TAP TYPE OF OCCUPANCY, NEW ❑ EXISTING SINGLE FAMILY ❑ COMMERCIAL ❑ MULT. RES. ❑ INDUSTRIAL FIXTURE UNITS DWELLING UNIT'S _ ADDRESS OF STRUCTURE , _-22Z_30 (I p n ), c Permit Conditions: The applicant agrees to comply with all rules and reyL, tions of the Unified Sewerage Agency. When calling for an inspection, please refer to the Permit Number. The Permit expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit. fee, connection charge, line ta, fen and/or other charge) will be forfeited if the permit expires. The Agency daps miot guarantee the accuracy of the location of side sewr,er laterals. If the sewer Is not located at the measurenr!nt given, the installer shall prospect three feet in all direction! from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" r Perrd t at the current charge and the Agency will install a lateral. FEES, PERMIT FEE s 1c . cz) CONNECTION CHARGE 1.2�_I LINE TAP INSTALLATION OTHER ISSUES BV TOTAL • _-�L � A P P L ICA ---_ ---- i E SEWER PERMIT My 28466 ADDRESS OF STRICTURE LTU TAX MAP TAX LOT QU�RTER ------------ SECTION — L 0 T BLOCK OFAPPROV ED `? PATE 9 ISSt;F D BY DATE UF� I SSU NCE D.U. 'S REMARKS ` �+`12f i32t'ri PrP''' INSPECTION NOTICE City of Tigard Builu;ng Department 12420 S.W. M,in St. Tigard,Oregon N7->3 Pho : F32.411 Type of Inspection Date Requested A.M...1P.M. Address Permit Owner Lot # Builder The following 94nif0ing Code deficiencies are required to be corrected: Presenter) to Approved I Inspector Disapproved Date CALL FOR REINSPECTION L-1 YES El NO