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Permit A , CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT SWR2002 -00006 ; - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/25/02 SITE ADDRESS; 11258 SW 84TH AVE PARCEL: 1S136CB-10000 SUBDIVISION: ASH CREEK MEADOWS ZONING: R -7 BLOCK: LOT: 004 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTP IMPERV SURFACE: Remarks: Sewer permit for new single family detached residence. Owner: FEES ESLINGER BUILDERS INC Type By Date Amount Receipt 11575 SW PACIFIC HWY TIGARD, OR 97223 PRMT CTR 1/25/02 $2,300.00 27200200000 INSP CTR 1/25/02 $35.00 27200200000 Phone: 503 - 620 -9515 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued CL. --" ;(3ti:i tii Permittee Signature: iy A Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busines ay