Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2012 -00155
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/30/2012
Parcel: 1S 136CA09000
Jurisdiction: TIGARD
Site address: 11047 SW LEGACY OAK WAY
Project: White Oak Village, Lot 11 Subdivision: 'WHITE OAK VILLAGE Lot: 11
Project Description: Sewer connection for new SF
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Contractor: Owner: WESTLAND INDUSTRIES INC
12670 SW 68TH #400
TIGARD, OR 97223
PHONE: PHONE: 503 - 572 -0746
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/30/2012 $4,500.00
Sewer Inspection - Residential 07/30/2012 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
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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 ob = col,_ of = ules o direct questions
to OUNC by calling 503.232. 9 7 or 1.800.332.2344. /
Issued By: Permittee Signature: �� gr 3
Call 503.639.4175 by 7:00 a.m. for the next available inspecti rte.
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.