Permit i
SEWER CONNECTION
CITY OF GAR D .. . PERMIT 6
.REKNIT �`#< < . CWR56- 0080
• COMMUNITY. DEVELOPMENT DEPARTMENT. • DATE ISSUED: 03/13/n
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL; 1S133CD —p'BI 13f
SITE ADDRESS...: 11 ^21 SW Tl LLWOOD 6R ' .
SUDDI'VISICN... e e PEBDLECREE•{ 'II ZONING: R-25
DLCCRe......... , LOT „,..e...:...e .34 - .
'i E NANT NAME... e .. V • .
USA NO... e . e ...... FIXTURE UNITS- .. ; O. .
CLASS OF WORN... e ;NEW . - DWELLING UNITS, . t 1 .
TYPE OF USE.... e e SF NO OF BUILDINGS; 1
INSTALL TYP'E.. e, e B_.USWR I MPERV SURFACE: 0 sf
Remarks: PATH I
Owner ._.__..__-.__..---__..---------•-- ....----._._._.- ._..__... -_ -._, _. -. .�--- ....- .-.. -. FEEL .-- ._J._-
COSTA PACIFIC HOMES 'type an.ount- by date . recpt
8623 SW CASCADE BLVD PRMT * 2200.00 BON 03/13/96 96- 276926
SUITE 4606 INSr' t ,6,7J. 00 BON 43/ 13/96 96- 276926
BEAVERTiON CR 970108 .
Rh•on e 4;4 646 -8888 . •
Coat r ;yet or e -- _ _._.
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CONTRACTOR . NOT ON I • I LE . .
Phone %e • $ ' 2235.000 TOTAL
Reg 4... .
. • • ----,--- REQUIRED INSPECTIONS - - - - -- • - -• --
This Applicant agrees to cocply with all the rules and reTliations Sewer Inspection _
of the unified Sewage Agency. The, peroit expires id's f;
days -: _ • .
the date issued. The total aNuat paid will be forfeited if the . _ _
pe ;nit expires. The Agency does it guarantee the accuracy . f the
side setve:' laterals. If the sewer is .'t located at the Ceasureoent _
given, the installer shat ::•'cspect 3 fee. in all directions fro _ •
the distance. given. If not s;, 'netted, the in.`'ller shall purchase _
a "lap and Side Sever' Parnit ant, the Age„ ;r_Il _-stall a lateral. _ .
Perm i.ttee Sign t'..re / ....01. _ ____� _� _ •
I is a :..t a c1 By .' / .�.�__ .-�._ .�.- _ _
Call for inspection • 639 -4175 .
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