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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection ���
Date Requested F 1- Time A.M.—A�P.M—
.
Address �„'� C�l� �_ •� ./�%+ �L'~ --..._—� Permit # —
Owner --— - _--- ---- ----
------ ------ of ---- --
Builder ----------___._ --- ��-- --- —The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector lei. t_ — _ ❑ Disapproved
Date �► _ —
CAL FOR REINSPECTION
0 Y.13 0 NO
SEWER PERMIT N? 27941
Uf
Unified Sewerage Agency 'of Washington County C I TY OF ___ DATE U Ae�l
OWNERPHONE
OWNER' S ADDRESSs
TYPE OF INSTALLATIONS
U BUILDING SEWER ❑ (_ INE TAP AND BUILDING SEWER ❑ LINE TAP
TYPE OF OCCUPANCYt
NEW EXISTING SINGLE FAMTLY ❑ COMMERCIAL
❑ MULT . RES. ❑ INDUSTRIAL.
FIXTURE UNITS DWELLING UNI1S
ADDRESS OF STRUCTURE t C ` l � ��� �9.
Permit Conditions: The applicant agrees to comply with all rules and regulations of ti,P Unified
Sewerage Agency. When calling fnr an inspection, please refer to the Permit Number. Tho Permit
Qxrires one hundred twenty (120) days from the da"e of issuanLQ. The total amount paid (permit
fee, connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall prospect three feet in all directions
from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer"
Permit at the current charge and the Agency will install a lateral.
FEES,
PERMIT FEE
CONNECTION CHARGE—
LINE TAP INSTALLATION
—5 _ ISSUED BY
TOTAL
APPLICANT — DATE
NOTICE: DAYS FROM THE
"$BOVEDATE,SEMfERSERVICE SEINER PERMIT N" 27941
CHARGE WILL BEGIN FOR THIS Pow.
ADDRESS OF STRUCTURE Com!',9
- -. .
TAY MAP (AX LOT QUAVER SECT ION -- —
LOT J/ BI..00K _ _ OF
PROVFD BY DATE �! ISSUED BY DATE Or ISSJANCE
D. U. ' S _� R E M A R KS �� �' �t�( _�-c, Z-rc calm. ^�
August 13, 1984
CITYOF TIFARD
WASHINGTON COUNTY,OREGON
Mr. 6 Mrs. A.C. Bryan
14319 Old Military Rd. East
Puyallup, Washington 98373
Re: Sewer Hook Up Fees for your place at 9300 SW Uurhdm Rcad, Tigard
Dear Folks,
It has been found that your place was assessed for sewer main that T.D.0
installed across the street from your place, when, you hooked to sewer.
'therefore I am returning your check / 1405 For $3000.00. Please bend us a
new check for $222.22 for above assessment.
-STnRmi''
F. T. Waldenn,,�
Building Official
0560P
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-- 12755SW ASH P.O. BOX 23397 TIGA7D, OREGON 97223 PH:639-4171 _