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CITY OF TIGARD SEWER CONNECTION PERMIT
_ COMMUNITY DEVELOPMENT Permit#: SWR2021-00273
Date Issued: 11/4/2021
TIGARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 101 AA08700
Jurisdiction: Tigard
Site address: 12511 SW 68TH AVE 150
Project: Dr Snip Subdivision: WEST PORTLAND HEIGHTS Lot: 34
Project Description: .56 EDU increase.
Contractor: Owner: TIGARD TRIANGLE PROPERTIES LLC
3232 SW FAIRMOUNT BLVD
PORTLAND, OR 97239
PHONE: PHONE:
FAX:
FEES
•
Description Date Amount
Specifics: Sewer Connection Fee 11/02/2021 $3,407.60
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: .56
Total $3,407.60
Required Items 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 set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Ho-L(,y Va.w De,v/eye• Permittee Signature: Qw Ap-p-Lizcotio-tA,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.