Permit nMANC C LUI NMU I . UIV
PERMIT
CITY OF T DATE 06/25/96 -0177
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 251 04BA -1 1600
SI TE131e1M6lan.d:T.'eyd, flea 72 J ISM a n1
SUBDIVISION • CASTLE HILL NO. 3 ZONING: R -12 PD
BLOCK LOT •146
TENANT NAME °
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 I
Owner: FEES
DON MORISSETTE HOMES type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 B 06/25/96 96- 280954
SUITE 151 INSP $ 35.00 B 06/25/96 96- 280954
LAKE OSWEGO OR 97035
Phone #: 620 -7538
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 1 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 Si ature: ,
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Issued By: . i,, yL'�
Call for inspection — 639 -4175