Permit C ITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT PERMIT #: SWR2007 - 00129
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/22/2007
PARCEL: 2S104DB - MC010
SITE ADDRESS: 13260 SW MAPLECREST CT ZONING: R -4.5
SUBDIVISION: MAPLECREST LOT: 010 JURISDICTION: TIG
PROJECT: MAPLECREST
Project Description: Sewer connection for new SF.
TENANT NAME:
CWS NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1.0
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Owner: FEES
WINDWOOD CONSTRUCTION INC
12655 SW NORTH DAKOTA Description Date Amount
TIGARD, OR 97223
[SWUSA] Sewer Connection Fee 6/22/2007 $2,700.00
[SWINSP] Sewer Inspection Fee 6/22/2007 $35.00
Phone: 503- 780 -7375 Total $2,735.00
Contractor:
Contact #: REQUIRED ITEMS AND REPORTS
Reg #:
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the
date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer
laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given.
If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon
law requires you to follow 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 copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued 41/fly l A b / "/ Permittee Signatur
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.