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Permit CITY OF TIGARD SEWER CONNECTION PERMIT 14 r� COMMUNITY DEVELOPMENT Permit #: SWR2009 -00097 Date Issued: 10/30/2009 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DC07200 Jurisdiction: Tigard Site address: 7131 SW ASH CREEK CT Subdivision: ASH CREEK ESTATES Lot: 5 Project: Ash Creek Estates Project Description: Sewer connection for new SF • FEES Owner: ASH CREEK PROPERTIES LLC Description Date Amount 12655 SW NORTH DAKOTA ST Sewer Connection Fee 10/30/2009 $3,600.00 TIGARD, OR 97223 Sewer Inspection - Residential 10/30/2009 $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 I w- -All -work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuan , or if work is sus -nded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utili Notification Center. T •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or irect questions to OUNC • calli ,• 5o .246.6699 or 1.800.332.2344. sued By: 0 1 / Permittee Signature: 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.