Permit 'CITY OF TIGARD SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DF RTIIII T PERMIT # • SWR94 - 0231
13125 SW Hall Blvd. Tigard, Oregon 97223.819 03) 71 DATE ISSUED: 06 /23/94
PARCEL: 2S104BB -01300
SITE ADDRESS...: 14323 SW WINDSONG CT
SUBDIVISION • CASTLE HILL ZONING: R -12 PD
BLOCK LOT •054
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
ED WHITLOW type amount by date recpt
16646 SW AMY HW PRMT $ 2200.00 SW 06/23/94 —
INSP $ 35.00 SW 06/23/94 —
BEAVERTON OR 97
Phone #: 591 -5380
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 2235.00 TOTAL
Reg #...
REQUI RED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 1:.'. 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: _ f_�_�
Issued By:4
Call for inspection — 639 -4175
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