Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2013-00177
T'GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2013
Parcel: 2S102DB00601
Jurisdiction: Tigard
Site address: 8855 SW OMARA ST
Project: Downs Subdivision: BURNHAM TRACT Lot: 8
Project Description: Connect existing house to sewer service,approximately 40'. Septic tank is to be pumped and filled.
Contractor: Owner: DOWNS, MATTHEW JACK
8855 SW OMARA ST
TIGARD,OR 97223
PHONE: PHONE: 503-380-1325
FAX:
FEES
Description Date Amount
Specifics: Deferred Reimbursement District Fee 08/12/2013 $13,513.70
Deferred Sewer Connection Fee 08/12/2013 $4,800.00
Type of Use: SF Deferred Sewer Inspection Fee 08/12/2013 $35.00
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $18,348.70
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 r - -•- 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 . mg 503.232.1•:7 • .801.3 .2344.
Issu'• By: if Permittee Signatu e:
Call 503.639.4175 by 7:00 a.m.for the next available lnspectio 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.