Permit r � ' � � CITY OF TIGARD SEWER CONNECTION PERMIT
Permit #: SWR2009 -00078
- COMMUNITY DEVELOPMENT
13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/24/2009
•T i G \ AR I Parcel: 2S 109AC04900
Jurisdiction: Tigard
Site address: 14612 SW 133RD AVE
Subdivision: WILSON RIDGE NO. 2 Lot: 17
Project: Wilson Ridge 2
Project Description: Connect new SFR to sewer.
FEES
Owner:
STONE BRIDGE HOMES NW LLC Description Date Amount
BY VENTURE PROPERTIES INC, 4230 SW Sewer Connection Fee 09/24/2009 $3,600.00
GALEWOOD ST #100 Sewer Inspection - Residential 09/24/2009 $35.00
PHONE:
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, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific. Center. hose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct q -stions to OUNC y calling 503.246.6699 or 1.800.332.2344.
Issue. By: K _/ 10r , 4.4 _.. Permittee Signature: � v •
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.