Permit CITY OF T I GARD SEWER CONNECTION
- COMMUNITY DEVELOPMENT DEPARTMENT PERMIT
' 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PERMIT *. .. .. .. : SWR94 -0344
639 -4171 DATE ISSUED: 12/01/94
PARCEL: 1S125CA —SW002
SITE ADDRESS...: 07440 SW TAYLORS FERRY RD
SUBDIVISION ° MLP94-0009 ZONING: R-4.5
BLOCK........... LOT..... ........ :002
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..: :sf
Remarks: PATH I
Owner: FEES --------
TONY & JANE CARLSON type amount by date recpt
7000 SW VERMONT CRT #411 PRMT $ 2200.00 KS 12/01/94 —
INSP $ 35.00 KS 12/01/94 —
PORTLAND OR 97223
Phone #F: 293 -3272
Contractor: — ------- _.__ —_-
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #t.. .
—• REQUIRED INSPECTIONS -----
This Applicant agrees to cooply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The peroit expires 180 days from ___._. - ,_„___,_,
the date issued. The total amount paid will be forfeited if the
peroit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the oeasureoent _
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" peroit and t Agency wi 1 - nnstall a lateral.
Permittee Si nat�_�re: oJ�IR�`�-'_ --- _ ____W
I s s u e d By : C,YALA __ _. _ ._ _ _. ___ _
Call for inspection — 639 -4175
L I . ol SI 2— 33