Permit a
CITY OF TIGARD SEWER CONNECTION PERMIT
111 II
3 . COMMUNITY DEVELOPMENT Permit #: SWR2009 00004
Date Issued:
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104BB13000
Jurisdiction: TIG
Site address: 14146 SW WALNUT CREEK WAY
Subdivision: Lot:
Project: WALNUT CREEK SUBDIVISION
Project Description: New SF
Owner: FEES
MATRIX DEVELOPMENT DBA LEGEND HOMES Description Date Amount
12755 SW 69TH AVE SUITE #100 [SWUSA] Sewer Connection Fee 03/24/2009 $3,100 00
PORTLAND, OR 97223 [SWINSP] Sewer Inspection Fee 03/24/2009 $35.00
PHONE: 503 - 620 -8080
Contractor:
PHONE.
FAX:
Type of Use: SF
Class of Work: NEW
Install Type: LTPSWR
Fixture Units:
Number of Dwelling Units: 1.0
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 Notificati C -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Issued ( ,,, „i9,. Permittee Signature fc. 5._.u f
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.