Permit CITY OF T SEWER CONNECTION
,„ ` . ,.� DEVELOPMENT SERVICES PERMIT
N-1 1
/3125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATT PERMIT 966 -0498
S : 4 E ISSUED: 11/04/96
PARCEL: 2S104BA- 10600
SITE ADDRESS...: 13665 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO. 3 ZONING: R -12 PD
BLOCK • LOT • 136
TENANT NAME :DON MORISSETTE 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 I
Owner: FEES
DON MORISSETTE HOMES type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 B 11/04/96 96- 286073
INSP $ 35.00 B 11/04/96 96- 286073
LAKE OSWEGO OR 97035
Phone #: 620 -7638
Contract or:
CONTRACTOR NOT ON FILE
Phone #: $ �� -2�
�5.00 TOTAL
Reg #..
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
of the Unified Sewage Agency. The permit expires l88 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: , AL & .A AA
I ssued By • ( l,U I /
Call for inspection — 639 -4175