Permit n CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2009 -00023
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/23/2009
Parcel: 2S111AB03601
Jurisdiction: Tigard
Site address: 9190 SW MOUNTAIN VIEW LN
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Subdivision: Lot: 0
Project: Hollenbach
Project Description: Connect to sewer.
FEES
Owner:
JOHNSON, HELEN M TRUST Description Date Amount
BY HELEN M JOHNSON TR, 9190 SW Sewer Connection Fee 04/23/2009 $3,100.00
MOUNTAIN VIEW LN Sewer Inspection - Residential 04/23/2009 $35.00
PHONE:
Contractor:
HOLLENBACH & HURD, INC
3430 A SW 209TH AVE
PORTLAND, OR 97007
PHONE:. 503 - 591 -5987
FAX: 503- 848 -6832
Type of Use: SF
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,135.00
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 Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Issued By: y, ' Q {n f l Ca` \ (1 A l Permittee Signature: i� %/ .
`0 `r"' ` Call 55033..��66339��� �
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.