Permit SEWER CONNECTION
. ITY CO F TIGARD PERMIT #PERMIT • SWR96 -0276
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/01/96
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S104BA -1200
SITE ADDRESS...: 13581 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK • LOT •142
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 type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 JSD 08/01/96 96- 282408
SUITE 151 INSP $ 35.00 JSD 08/01/96 96- 282408
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #..
REQU I RED INSPECTIONS --
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
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: �1 �►. ���i`.�
I ssued 4111
Call for inspection — 639 -4175