Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2013 -00027
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/07/2013
Parcel: 1 S136CA08500
Jurisdiction: TIGARD
Site address: 11052 SW LEGACY OAK WAY
Project: White Oak Village, Lot 6 Subdivision: WHITE OAK VILLAGE Lot: 6
Project Description: Sewer connection for new SF
Contractor: Owner: WESTLAND INDUSTIES
12670 SW 68TH AVE, SUTIE 400
PORTLAND, OR 97223
PHONE: PHONE: 503 - 572 -0746
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/07/2013 $4,665.00
Sewer Inspection - Residential 05/07/2013 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
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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 Ore... Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtai .py of 'e r - 'r direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
(1) Issued By: 1 ( Permittee Signature: / I •_
JJJ Call 503.639.4175 by 7:00 a.m. for the next available inspection iate.
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.
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