11365 SW 121ST AVENUE a
11365 SW 121ST AVENUE
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WEf'TION NOTICE
City of Tigard Builoing Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested- _-_ __—��* S— TimeA.M. P.M.
Address �3 _'_ - 21 —.-- Permit
Owner — - -- ---_ ---- Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
C_ it '
Pretented to ❑ Approved
i
Inspector A ❑ Disapproved
Date _
CALL FOR REINSPECTION
0 YES ❑ NO
WIN- WWR ry li
HONG
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection 5cu'Ir,
F-I F
Date Requested Time A.M. P.M.
Address .1JGS 3w
Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented topproved
Inspector 01upproved
Date
CALL FOR REIP.73PECTION
El YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.U. Box 23397
Tigard, Oregon 97223
Phune: 839-4175
Type of Inspection _ .S�►,�`� r — — _ __
ate Requested .�–//_ g 7 Time A.M. `_=-P.M.
Address //��5=5`^� _ Permit # _
Owner _— — — Lot #� _
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
��_
Inspector �.__� __ U Dinpproved
Date
CALL FOR REINSPSC77ON
YES ❑ NO
1� F IN IN
SEWER PERMIT 33427
Uniflod Sew.ra"Agww:y
of Washington County CITY OF _may g� r1 DATE 5-6-87
OWNER: Robert Maclean PHONE : 639-0441
OWNER'S AGORESS, __11 -36,5 SW 121Qt AyQ�
rTTY�PE OF INSTALLATION: �
U BUILDING SEWER ❑ LINE TAP AND BUILDING SEWER ❑ LINE rar
TYPE OF OCCUPANCY:
❑ NEW [y] EXISTING u SIPIGLE FAMILY ❑ COMMFRCIAL
❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
ADDRESS OF STRUCTURE , 11.365 SW 121st Ave, 97223 _
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified
Sewerage Agency. When calling for an inspection. please refer to the Permit Number. The Permit
expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit
fee, connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall. prospect three feet in all directions
from the distance given. if not so located, the installer shall purchase a "Tap and Side Sewer"
Permit at the ct-rrent charge and the Agency will install a lateral.
FEES:
PERMIT FEE s 35. 00
CONNECTION CHARGE 300.0
LINE TAP INSTALLATION
OTHER
ISSUED BY
— �
r/C,�� �
TOTAL s 335.00
DATE OF ISSUANCE
i
APPLICANT DATE OF EXPIRATION
SEWER PERMIT
ADDRESS OF STRUCTURE 11365 Sat Ave
.
TAX MAP 1S1-34CB TAX LOT QUARTER
SECTION -
LOT BLOCK _ 01
BCR 5-7-87APP
ROVED BY DATE U BY DATE 0 ISSUANCE
D. U. 'S 1 REMARKS 4" dine read. RJR sBp tank to hr, t
6 filled w/gravel , inspection required by city.
May 8, 1987
a
RE : Tax Lot #208/Mr. & Mrs . MacLean
Mainline participation
To Whim it May concern :
Mr & Mrs. MacLean have been very cooperative to work with in the
mainline participation so that they can get the sewer extended to
their property.
Tom Miller
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