Permit CITY OF TIGARD SEWER CONNECTION PERMIT
11 1 s COMMUNITY DEVELOPMENT Permit #: SWR2013 -00068
1 3125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 04/17/2013
TIGARD 13125 2S112BD08700
Jurisdiction: Tigard
Site address: 7758 SW CORNUTT ST
Project: Brittany Meadows, Lot 23 Subdivision: BRITTANY MEADOWS Lot: 23
Project Description: Sewer connection for new SF
Contractor: Owner: PACIFIC EVERGREEN HOMES LLC
7410 SW OLESON RD #133
PORTLAND, OR 97223
PHONE: PHONE
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 04/17/2013 54.665.00
Sewer Inspection - Residential 04/17/2013 $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 54.700 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. Those rules are 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 by ' g 503. -. 987 or 1.800.332.2344.
Issued y: I N 4 - � 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.