Permit , ■
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CITY OF TIGARD SEWER CONNECTION PERMIT
3 -. COMMUNITY DEVELOPMENT Permit #: SWR2009 -00070
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/28/2009
Parcel: 2S104BD10000
Jurisdiction: Tigard
Site address: 12631 SW 135TH AVE
Subdivision: ALEXANDER PARTITION Lot: 2
Project: Alexander Partition
Project Description: 1 EDU sewer connection for new SF, maximum of 5 bedrooms.
FEES
Owner:
ALEXANDER LIVING TRUST Description Date Amount
BY MARION /DOMINIQUE ALEXANDER TRS, Sewer Inspection - Residential 10/28/2009 $35.00
12645 SW 135TH AVE Sewer Connection Fee 10/28/2009 $3,600.00
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 Notifi atierreerrte . hose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direc uestions to OUNC b ,calli 03.246.6699 or 1.800.332.2344.
Is ued By: _ Permi tee Signature: _ t
-f j`
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.
1` i
. ' `t CITY OF TIGARD SEWER CONNECTION PERMIT
` • 2 ' '. COMMUNITY DEVELOPMENT Permit #: SWR2009 -00070
114
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10(28(2009
TLARD Parcel: 2S104BD10000
Jurisdiction: Tigard
Site address: 12631 SW 135TH AVE
Subdivision: ALEXANDER PARTITION Lot: 2
Project: Alexander
Project Description: 1 EDU sewer connection for new SF, maximum of 5 bedrooms.
Owner: FEES
ALEXANDER LIVING TRUST Description Date Amount
BY MARION /DOMINIQUE ALEXANDER TRS, Sewer Inspection - Residential 10/28/2009 $35.00
12645 SW 135TH AVE Sewer Connection Fee 10/28/2009 $3,600.00
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: 2
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. �I .,� / igioidic.1
Issued By: -�I� �'�Q d /� Permittee Signature: l��p ;fri ' ,o
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.