Permit ,� CITY OF TIGAR SEWER CONNECTION PERMIT
114 * COMMUNITY DEVELOP Permit #: SWR2011 -00052
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 25111 BA02106
Jurisdiction: Tigard
Site address: 9835 SW INEZ ST
Project: Walker Subdivision: INGEBRAND HEIGHTS Lot: 13
Project Description: Connect existing house to sewer service.
Contractor: Owner: WALKER, SAMUEL JAY & JULIE LINDA
9835 SW INEZ ST
TIGARD, OR 97224
PHONE: PHONE: 503 - 443 -6085
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 04/12/2011 $4,100.00
Sewer Inspection - Residential 04/12/2011 $35.00
Type of Use: SF Reimbursement District Revenue 04/12/2011 $6,000.00
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $10,135.00
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. Thos- . = set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OUNC b ailing 503.232.1 • :7 • 8 • i 332.2344.
Issue . By: , , 4/ � Permittee Signatu
Call 503.639.4175 by 7:00 a.m. for the next available inspectio ate.
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.
W CITY OF TIGARD SEWER CONNECTION PERMIT
`•''� s COMMUNITY DEVELOPMENT Permit #: SWR2011 -00052
13125 SW Hall Blvd Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
TIGARD Parcel: 2S 111 BA02106
Jurisdiction: Tigard
Site address: 9835 SW INEZ ST
Project: Walker Subdivision: INGEBRAND HEIGHTS Lot: 13
Project Description:
Contractor: Owner: WALKER, SAMUEL JAY & JULIE LINDA
9835 SW INEZ ST
TIGARD, OR 97224
PHONE: PHONE: 503 - 443 -6085
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 04/12/2011 $4,100.00
Sewer Inspection - Residential 04/12/2011 $35.00
Type of Use: Reimbursement District Revenue 04/12/2011 $6,000.00
Class of Work:
Install Type:
Fixture Units:
Number of Dwelling Units:
Total $10,135.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if
work is sus • - • • - • • more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. ose rules are -t forth in 0AR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OU • C by calling 503.232.19: .:4$.332.2344.
Is ued By: / r /I r / Permittee Signature: Y 4's`"W/rl 'j44
Call 503.639.4175 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.