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10165 SW HILLVIEW STREET 4k. 101.65 SW HILL VIEW STREET SPR I N_-OPT Um mL of Tigard Building Depart—nt 13125 Sit Hall Blvd. Tigard. Oregon 972]. kQ Inspoction Line tRec-O-Phone): 639-4171, Business Phoney 619-4171 Inspection: -_-- - ��—�-- rooting ploq. Underelab Hach. Rough-:_n APpr/5dwlk Pound. P'.bg. top Out Gas I.ine FINAL: /�'.�^ ) eramin -Bldg. m Post/Boa3truct. '•� San'��e.1 9 Post/BP,,s, Mach. Rein Drain Insulation -Plumb. -Mach. Plby. Underfloor Nater Line Gyp. By PK Date Requesttedt Address:_ 1 I _�•—� .3i1 Z.'�— "'rmtt #, - p/•3 "�_ Bu11r,ar:_ --- TNF FOLLOWING. CORRRCTlON3 ARF.. VzQt'IRED: ✓�� Date:— _ Inspector APPROVED DisAPPROVRD �.T APPROVED SUBJECT TO ABOVR / Call For Reinsp. SEWER CONNECTION CITY OF TiGrA T WYOFUMRD l LRM1 'f #. . . . , ., . : SWR91 _.0-" C©MMUNTY DEVELOPMENT DEPARTMENT 11,26 SW Hdl BW. P.O.Bm 2-0117,TipW,Oreo-47223(603)M-4176 � ,i i T F - ----- PARCEL: 2S102CC�--0�'.1'_A" E ADDRESS. . . s 142�1E, i SW HILL V7cin1 .�; ZONIN(.;: R—:3. 5 )I V I C I CIN. . . . . F REL.EON HEI(SIATS NO. 12 tE"K • LOT. . . . . . . . . . i;hAN'f NAME. , . . . : FIXTURE UNITS. . . SA NLS. . . .. . , • • • • : DWELL.I NO uN I T93. . : 1 I..-ASS OF WORK. . , :NEW NO. OF' BUILDINGS" 1 ypEW OF USE:. . . . . s SF IMPERV �",I.JRFAC1 . h157i=+L.i 'YPE. « , , :pLJSOR ematr•ks: FEES type by date r'r AIL_ PATRICIA HOL.TER 10165 SW HILL VIEW F'RMT fs 1500- 00 JLH NCS/c"'_7f91 . INSI7, 00 JLH 06/1'_7!91 II GORD OR 93 :23 'hr7nw #; word;rawc,t or,x 'ONTRACTOR NOT ON FILE 00 TOTAL Req #. . EZE:DU I RE':t7 INSPECTIONS — This Applicant agrees to comp'y with all the rules and reoulatior,s t;ewer Inspection :f the Unified Sewage Agencq. The permit expires 120 days fro' the date iss,ed. The total mount paid will be forfeited if the _.--•- permit expires. The Ager-,,v does not guarantee the accuracy of the side sewer lateral,. If the sewer is not located at the seasuresent _. _.-.-......_.____......_._.._- _.�_..._ _-___.___.__...__,..... given, the installer shall prospect 3 f'et it all direct ons fMl _ ---w-- --- the distance civ!n. If nct so located. the installer shall Ou"chase a ^Tao and Slot raawer" permit and the Agency will install a lateral. t1:we S1p116Ar.tr`eC Cull tc�r inspection 639-417" i Ii .e ' i REcEIPT OF r-lAYMENT RECEIP-l' NO, 19 J-PI 4 7 60 CIi rte' -f'Y OF TIGARD CHECK AMOUNT 1535. 160 r,Aqt4 (AMOUNT 10. 00 NAME 1101-TER, GAIL. & PATRICIA PAYMENT DATE":, 06/26/91 ADDRESSDIVISION IL41t,5 SW Hlt,.(-.VIEW SUB TIGARD, OR 97F.;?-3-- pURpOSU-. OF pAYMFNT OMOLINT PAIL' PURPOSE OF PAYMENT AMOUNT PAID INSPECT C6 C)F*WF;�R PF."-RMIT/StjsC(3NTRACT0R ISS NOT YET DECIDED UPON I UT OL AMOUNT PA I D 15,35- 00