Permit (41) CITY OF TIGARD SEWER CONNECTION PERMIT
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COMMUNITY DEVELOPMENTSWR2023-00180 Permit#: SWR2023 00180
T f GA Id I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2023
Parcel: 2S 110DCO2300
Jurisdiction: Tigard
Site address: 11545 SW DURHAM RD B-6
Project: Bull Mountain Orthodontics Subdivision: 1998-128 PARTITION PLAT
Lot: 1
Project Description: .19 EDU increase.
Contractor: Owner: HIP WILLOWBROOK LLC
BY HARSCH INVESTMENT CORP
PO BOX 2708
PORTLAND, OR 97208
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/30/2023
$1,258.75
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: .19
Total $1,258.75
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 -lose rules are s forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: ! �y Permiftee Signature: Se i
` N
Call 503.639.4175 by :00 a.m.for the next available inspection date.
This permit card shall be kept in onspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.