Permit (4) CITY OF TIGARD SEWER CONNECTION PERMIT
° COMMUNITY DEVELOPMENT Permit#: SWR2022-00018
Date Issued: 2/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S103AA00900
Jurisdiction: Tigard
Site address: 11000 SW WALNUT ST
Project: KEPHART Subdivision: ECHO HEIGHTS Lot: 6
Project Description: Sewer connection for existing dwelling.Septic tank to be pumped and filled.
Contractor: Owner: KEPHART, DAVID A&KIMBERLY D
11000 SW WALNUT ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 02/16/2022 $6,085.00
Sewer Inspection-Residential 02/16/2022 $35.00
Type of Use: SF
Class of Work: OTR
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $6,120.00
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
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Issued By: L � Permittee Signature:
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Cal 0 . 39.4175 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.