Permit CITY OF TIGARD SEWER CONNECTION PERMIT
a COMMUNITY DEVELOPMENT Permit #: SWR2010 -00102
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2010
Parcel: 1S135DB13300
Jurisdiction: Tigard
Site address: 9254 SW NORTH DAKOTA ST
Subdivision: HELLWEGE PARTITION Lot: 0
Project: Hellwege partition
Project Description: New SF
Owner: FEES
SEAMAN, MARK Description Date Amount
8407 SW 58TH AVE Sewer Connection Fee 09/08/2010 $4,100.00
PORTLAND, OR 97219 Sewer Inspection - Residential 09/08/2010 $35.00
PHONE: 503 -789 -5349
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 $4,135.00
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 -0100. You may obtain a copy of • = rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: mac- /' rm
eittee Signature:
_AO/ iy /L .IMF
Call 503.639.4175 by 7:00 a.m. for an inspection that busine ; 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.