Permit ill n� ��� CITY OF TIGARD IGAR� SEWER CONNECTION PERMIT
1 COMMUNITY DEVELOPMENT Permit #: SWR2010 -00163
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2010
TIt 'i, , . , g Parcel: 2S111 BD00302
Jurisdiction: Tigard
Site address: 9930 SW INEZ ST
Project: Bray Subdivision: PEMBROOK HEIGHTS Lot: 2
Project Description: Connect existing house to sewer service. Reimbursement District fee paid.
Contractor: Owner: BRAY TRUST
9930 SW INEZ ST
TIGARD, OR 97224
PHONE:
PHONE: 503 - 913 -7058
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 12/01/2010 $4,100.00
Sewer Inspection - Residential 12/01/2010 $35.00
Type of Use: SF
Class of Work: ALT
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 suspe•. -• for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. ose rules a set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions
to OU "C by cal ing 503.232. , 9; . 1.80 :.332.2344.
i •
Is ued By: , // 4 0 1 Permittee Signature: .1 I .I 77
Call 503.639.4175 by 7:00 a.m. for the next available inspec /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.