Permit — p CITY OF TIGARD SEWER CONNECTION PERMIT
'`7 • COMMUNITY DEVELOPMENT Permit#: SWR2015-00009
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/12/2015
Parcel: 2S101AB00600
Jurisdiction: Tigard
Site address: 12260 SW 72ND AVE
Project: Guilleux Subdivision: 1996-024 PARTITION PLAT Lot: 2
Project Description: Connect existing house to sewer service.Septic tank is to be pumped and filled.
Contractor: Owner: GUILLEUX, FEMY
11424 SE ORIENT DR
BORING,OR 97009
PHONE: PHONE: 503-481-1212
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 02/12/2015 $4,900.00
Sewer Inspection-Residential 02/12/2015 $35.00
Type of Use: SF
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $4,935.00
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 b - Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a •• of t - rules or direct questions
to OUNC b mg 503. ' .1987• 1.800.332.2344.
Issue By: / 0' Permittee Signature:
JO
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 • ••
.
Approved plans are required on the job site at the time of each inspection.