Permit .'- F' CITY OF TIGARD SEWER CONNECTION PERMIT
i ' COMM UNITY DEVELOPMENT Permit #: SWR2010 -00164
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02!18/2011
Parcel: 2S109DA14100
Jurisdiction: TIGARD
Site address: 12651 SW MOUNT VISTA CT
Project: Arlington Heights No. 3 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 60
Project Description: Sewer connection for new SF.
Contractor: Owner: STONE BRIDGE HOMES
16869 SW 65TH AVE #505
LAKE OSWEGO, OR 97035
PHONE: PHONE: 503 - 387 -7577
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 02/18/2011 $4,100.00
Sewer Inspection - Residential 02/18/2011 $35.00
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 -0090. You may obtain a co• e the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By _ Permittee Signatur . ,rte . _Z''.-. -
Call .0 -' 75 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.