Permit — CITY OF TIGARD SEWER CONNECTION PERMIT
` s F COMMUNITY DEVELOPMENT Permit #: SWR2011 -00067
Date Issued: 06/10/2011
i>Gf"yARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S104AD05400
Jurisdiction: Tigard
• Site address: 12826 SW SEVILLA AVE
Project: Walnut Crossing, lot 1 Subdivision: WALNUT CROSSING Lot: 1
• Project Description: New SF.
• Contractor: Owner: PAHLISCH HOMES, INC.
63088 NE 18TH, STE 100
BEND, OR 97701
PHONE: PHONE: 541 - 385 -6762
FAX:
FEES
Description Date Amount
.Specifics: Sewer Connection Fee 06/10/2011 • $4,100.00
Sewer Inspection - Residential - 06/10/2011 $35.00
Type of Use: SF •
Class of Work: NEW
Install Type: Line Tap and Building Sewer •
Fixture Units:
Number of Dwelling Units: 1
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Total $4,135.00,
Required Items and Reports (Conditions)
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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 t • _ • • •AR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503. 2.1987 or 1:800.3 . -
Issued B / Permittee Signature:
Lam - � � /tea
Call • — 5 by 7:00 a.m. for the next available inspect' n•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.