Permit CITY OF T SEWER CONNECTION
1 ' iuT,, DEVELOPMENT SERVICES PERM T
'' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT S • 2W 977 —� 28
DATE ISSUED: 02/12/97
PARCEL: 2S104BA -10800
SITE ADDRESS...: 13627 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO. 3 ZONING: R -12 PD .
BLOCK • LOT • 138
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: New SFD
Owner: FEES
DON MORISSETTE HOMES type amount by date recpt
5000 SW MEADOWS RD PRMT $ 2200.00 B 02/12/97 97- 290291
STE 151 INSP $ 55.00 B 02/12/97 97- 290291
LAKE OSWEGO OR 97035
Phone #: 620 -7538
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #..:
REQUIRED INSPECTIONS --
This Applicant agrees to cooply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total mount, paid will be forfeited if the
pewit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the oeasure.ent
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° Per.it and the Agency will install a lateral.
Permittee Sig � ture: ' , Wad
Issued By: AO L
Call for inspection — 639 -4175