Permit f
CITY OF TIGARD
SEWER CONNECTION
DEVELOPMENT SERVICES PERMIT
'` 'Li. . 1,125$WIIeAt, Not CtA97223 (509) 8394171 PERMIT # • SWR97 - 0152
DATE ISSUED: 05/20/97
PARCEL: 28104CC —HW029
SITE ADDRESS... :13179 SW ASCENSION DR
SUBDIVISION.... :HILLSHIRE WOODS ZONING: R -7 PD
BLOCK LOT •029 JURISDICTION:
TENANT NAME •WINDWOOD HOMES
USA NO : FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE :SF NO. OF BUILDINGS: 1
INSTALL TYPE....:BUSWR IMPERV SURFACE: 0 sf
Remarks: Path 1
Owner: -- FEES
WINDWOOD HOMES INC type amount by date recpt
14076 SW BENCHVIEW TERR PRMT $ 2200.00 JMH 05/16/97 97- 294705
TIGARD OR 97224 INSP $ 35.00 JMH 05/16/97 97- 294705
Phone #:
Contract or:
OWNER
Phone #: $ 2235.00 TOTAL
Reg #..
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The pereit expires IN days free
the date issued. The total aeount paid will be forfeited if the
pereit expires. The Agency does not gum ante. 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 free
the distance given. If not so located, the installer shall purchase
a 'Tap and Side Sewer' Pereit and the Agency will install a lateral.
Permittee Signature: tizaa.,)
Issued By: ',. % •
Call for inspection — 6 19 -4175