15070 SW 81ST AVENUE ADDRESS:
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CITY CSF T I GARD : ��._8� � .iY 1 r t.s i i Gi'r r /
COMMUNITY DEVELOPMENT DEPARTMENT . . . . . .
13125 SW Hall Blvd.Tigard,Orogon 97223*8199 (503)539-4171
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IXTURE.
UNI TS—
DWELL T NG UN 11"5. .
Up LL.L. . . . . . .Z:)I-. NU- OF BUILDINGS.,
I-ALL 1
i-'U1vVLiJ1 PILLED, i4041) 114SPLLI'L.D.
ONL BARIDF type anjumnt uy date
`J 0 7 0 $ 300. 00 JH
I N!.j, 35. 00 Jif
REAUIPED IN6PE,"
1! A JON—
iy tigrets to coapiy with aij the rules ann regulations in�Peatiw'k
the UlnififiC' Sewage Agm . Tl-,e persiL enpirp,, IR naffs flt-Qo
data m4ed- the total asount paid hill ot t
'w".eitid ;.' the
"I" '10-ts- 'he A&MY does nott'e accuracy of ve
1# :06pl laterals. If tne sexr is not lo'catt'j, at the ansuresent
IngtAllf( Shall prospect 3 451 1 all directi�ri (rar:
)Stdliv shat! vkirc.-ase
In S ovct xan 639—+41'75
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.L�!SPECfION NOTICE
City of Tigard Building Departtemut
13125 " Hall Hint. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone)c 639-4175 Business Ph e: 639-4171
Inspection:
Footing Plbg. Dndetelab Mach. Hough-Ln App /Sdwlk
Found. Plbg. Top Out Gaa Line FINAL:
Poet/Beam Struct, alto. slYNt� Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Pi:;. Underfloor Nater Line Gyp. ad. -Hoch. U
Date Recr:ested:- '! ) -3 ^___Time: AMC;IPk
Address: .1_15il 10 ��/ Permit It��� V�.6 X
Builder:
THE F'oLLmima OORucrrows ARi RsQDIREDt
7a A,Grp.✓
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Inspector: _- Datot � f
1/_ VRD APPROVND Ots"PRtWao APPROSOMOMT TO AMM
Y _Call For PASin$p.
1-*,lTV Or- TICARD wmivv nF PAYMU11T RF['ElPT NO. a 93-239076
CHECK AMOUNT 33.*5. 00
14AME s SARDELL, EARL. CASH AMOUNT 0. 00
ADDRESS L 15070 SW SIST PPYMENT DATE 04/15/93
SUBDTV19ION
TTGART), OP 9-7224---
PURr'IOSE OF PAYMENT AMOUNT PAID PURPOSF OF PAYMENT AMOUNT PAID
US()
Ln 300. 00 S 35. 00
LLI
lf.,'.WFR CONNECTION PERMIT
Tf*)(Al. AMOLINT PAID 33n, 00
ALOHA SANITARY SERVICE
P.O. BOX 309, BAIV KS, OREGON 97106
644-2797 / 648-6254 / 324-4343 / 639-5188
NAME / �+ 117
------
/ 119 _
ADDRESS -�
PHONE HOME WORK _
JOB SITE
h,
CHARGE: 0 PAID BY CHECKT CASH � VISA
DRIVER
AMOUNT
/
- - MARKS - -
TYPE OF TANK: STEEL I CO CRETE/PLASTIC / OTHER
HORIZONTAL I VERTICAL I RECTANGLE / OTHER
SIZE OF TANK: 350 / 500 b / 1000 i 1250 / 1500
LID LOCATION: INLET / OUTL , / MIDDLE / OTHER
CONDITION OF TANK: GOOD S� I IR / POOR
FITTINGS: RAPPELS I CyONCRETE / CAST IRON / PLASTIC
NEEDS NEW LID C SIZE _. ___
GROUND COVER OVER 1ANK -_ _
i
COMMENT CNC ND ION OF DRAI IELD ETC.
R RECEIVED BY
N TOTAL ,
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