Permit CITY OF TIGARD SEWER CONNECTION PERMIT
II COMMUNITY DEVELOPMENT Permit #: SWR2012 -00006
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/17/2012
Parcel: 25111 BD00406
Jurisdiction: Tigard
Site address: 9675 SW MARILYN CT
Project: Fannie Mae Subdivision: DARMEL NO.3 Lot: 27
Project Description: Connecting existing house to sewer. Reimbursement district fees paid.
Contractor: Owner: FEDERAL NATIONAL MORTGAGE ASSN
BY RECONTRUST CO
400 NATIONAL WAY
SIMI VALLEY, CA 93065
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/17/2012 $4,500.00
Sewer Inspection - Residential 01/17/2012 $35.00
Type of Use: SF Reimbursement District Revenue 01/17/2012 $10,076.18
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $14,611.18
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 -0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503. — :7 or 1.800.332.2344 _
Issued By: , - Permittee Signature:
Call 503.639.4 • a.m. for the next available inspection date. :00
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.