Permit CITY OF TIGARD
SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639-4171
PERMIT # SWR94 -0358
639 -4171 DATE ISSUED: 11/01/94
PARCEL: 25114A0 —WE031
SITE ADDRESS ° ° °: 08910 SW WAVERLY DR
SUBDIVISION ° WAVERLY ESTATES ZONING: R -12
BLOCK LOT -031
TENANT NAME
USA NO 'FIXTURE UNITS... :
CLASS OF WORK... :NEW DWELLING UNITS.. :1
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TYPE OF USE °SF NO OF BUILDINGS :1
INSTALL TYPE •BUSWR IMPERV SURFACE— : :sf
Remarks: PATH I
Owner: FEES - - --
MEL WAYMIRE type amount by date recpt
P 0 BOX 231164 PRMT $ 2200.00 JF 11/01/94 —
I NSP $ 35.00 JF 11/01/94
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TIGARD OR 97223
Phone #: 639 -6742
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #° ° °
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 1B@ 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 wil install a lateral.
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Permittee Signature: fiL/ ./Ak" /
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Issued B y:
Call for inspection — 639 -4175