Permit L CITY OF TIGARD SEWER CONNECTION PERMIT
° COMMUNITY DEVELOPMENT Permit #: SWR2010 -00046
T IGAR6 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/07/2010
_ f Parcel: 2S109AB14500
Jurisdiction: Tigard
Site address: 13372 SW OUZEL LN
Subdivision: Lot: 0
Project: Alpine View
Project Description: Sewer connection for new SF.
FEES
Owner:
WEST HILLS DEVELOPMENT Description Date Amount
735 SW 158TH AVE Sewer Connection Fee 05/07/2010 $3,600.00
BEAVERTON, OR 97006 Sewer Inspection - Residential 05/07/2010 $35.00
PHONE: 503 - 641 -7342
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,635.00
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, o ' - • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N.. ification Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire' questions to OUN .y 503.246.6699 or 1.800.332.2344.
Issue= By: i ` � , Permittee Signature: 76. j c11
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.