Permit CITY TIGAIAIRD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PERM I T
13125 SW'Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERM I r # SWR94 -0045
639 -4171 DATE ISSUED: 02/11/94
PARCEL: 2S104CA -10300
SITE ADDRESS ° °.: 13691 SW JENNA CT
SUBDIVISION ° °. ° : HILLSHIRE ZONING: R -7 PD
BLOCK ° °„ °°°° ° ° °° LOT °103
TENANT NAME.. °°°
USA NO ° ° ° °.°°°°°: FIXTURE UNITS ° ° °:
CLASS OF WORK. ° ° NEW DWELLING UNITS.. :1
TYPE OF USE °SF NO. OF BUILDINGS:1
INSTALL TYPE °BUSWR IMPERV SURFACE— : :s
Remarks: PATH I INSTALL FILL IN LIFTS COMPACT EACH LIFT NEED ENGINEERS REPOR
T
ON ANY FILL OVER 2 FT DEEP BEFORE BUILDING
Owner: FEES
PAHLISCH HOMES INC type amount by date recpt
15100 SW KOLL PARKWAY PRMT $ 2200.00 JH 02/11/94 —
SUITE E INSP $ 35.00 JH 02/11/94 —
BEAVERTON OR 97006
Phone #: 643 -4400
Contractor: —
CONTRACTOR NOT ON FILE
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 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' Permit and the Agency will install a lateral.
Permittee Signature: _221,&,„‘_...-5
/
Issued By '' _ j
OF
Call for inspection — 639 -4175