Permit CITY OF TIGARD SEWER CONNECTION PERMIT
a • COMMUNITY DEVELOPMENT Permit #: SWR2012 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/02/2012
Parcel: 1 S136CA09400
Jurisdiction: TIGARD
Site address: 11033 SW LEGACY OAK WAY
Project: White Oak Village, Lot 15 Subdivision: WHITE OAK VILLAGE Lot: 15
Project Description: Sewer connection for new SF.
Contractor: Owner: WESTLAND INDUSTRIES
12670 SW 68TH AVE STE #400
TIGARD, OR 97223
PHONE: PHONE: 503 - 572 -0746
FAX:
• FEES
Description Date Amount
Specifics:, Sewer Inspection - Residential 03/02/2012 $35.00
Sewer Connection Fee 03/02/2012 $4,500.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $4,535.00
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 Ore..n Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy o // _ Jr direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • ittee Signature:
Call 503.639.4 I 0 a.m. for the next available inspectioote.
This permit card shall be kept in a conspicuous place on the job site until c • pletion of the project.
Approved plans are required on the job site at the time of each inspection.