Permit CITY OF TIGARD SEWER CONNECTION PERMIT
11
s.. COMMUNITY DEVELOPMENT Permit #: SWR2012 -00115
Date Issued: 06/28/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S 136CA09700
Jurisdiction: TIGARD
Site address: 11096 SW LEGACY OAK WAY
Project: White Oak Village, Lot 18 Subdivision: WHITE OAK VILLAGE Lot: 18
Project Description: Sewer connection for new SF
Contractor: Owner: WESTLAND INDUSTRIES INC
621 SW ALDER ST, STE 605
TIGARD, OR 97223
PHONE: PHONE: 503 - 780 -0626
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/28/2012 $4,500.00
Sewer Inspection - Residential 06/28/2012 $35.00
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.on Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain copy of th- .r direct questions
to OUNC by c ing 5 232.1987 r 1.800.332.2344.
Issued By Permittee Signature: g
Call 503.639.4175 by 7:00 a.m. for the next available inspection "re.
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.