Permit CITY OF TIGARD SEWER CONNECTION PERMIT
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COMMUNITY DEVELOPMENT Permit#: SWR2021-0001 1
Date Issued: 9/9/2021
T l(IA A It.I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 251048C10700
Jurisdiction: Tigard
Site address: 14044 SW WALNUT LN
Project: Fern Ridge,Lot 4 Subdivision: FERN STREET SUBDIVISION Lot: 4
Project Description: Sewer for new detached dwelling
Contractor: Owner: K5 URBAN PROPERTIES& MANAGEMENT LLC
PO BOX 25571
PORTLAND, OR 97239
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/08/2021 $5,800.00
Sewer Inspection-Residential 09/08/2021 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $5,835.00
Required hems and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are se rth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
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Issued By: ermittee Signature: CX'
� ' ��-'„�!Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Cf
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.