Permit . 'u CITY OF TIGARD SEWER CONNECTION PERMIT
Ilp
'- COMMUNITY DEVELOPMENT Permit #: SWR2013 00014
T 1GARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Date Issued: 02/21/2013
Parcel: 2S 104 DB06000
Jurisdiction: Tigard
Site address: 13286 SW MAPLECREST CT
Project: Maplecrest, Lot 7 Subdivision: MAPLECREST Lot: 7
Project Description: Sewer connection for new SF
Contractor: Owner: RICHARDS, M DALE .
ADAMS, HEATHER M
12655 SW NORTH DAKOTA
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 02/21/2013 $4,665.00
Sewer Inspection - Residential 02/21/2013 $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 $4,700.00
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 T e rules • - set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090 You may obtain a copy of the rules or direct questions
to OUNC calling 503.232 • - :7 . .0 332 2344
Issu d By: , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.