Permit C ITY OF T I GARD PERMIT S #_ CONNEC O fI SWR9E -0159
PERMIT
C OMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/11/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S109BA -HS227
SITE ADDRESS...: 14112 SW WAGONER PL
SUBDIVISION ° HILLSHIRE SUMMIT #2 ZONING: R -7 PD
BLOCK ° LOT .27
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 - - -• - - --
type amount by date recpt
. PRMT $ 2200.00 JSD 04/11/96 96- 278035
INSP $ 35 °00 JSD 04/11/96 96- 278035
Phone #:
Contractor:
CASCADE WEST CONSTRUCTION CORP
. 10445 SW CANYON RD SUITE 103
BEAVERTON OR 97005 - --
Phone #: 641 --7424 $ 2235.00 TOTAL
Reg #° ° : 62678 ,
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 18@ days fro®
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...a -: e
Issued By !""- '� c
Call for inspection - 639 -4175
•