Permit III q
CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2015-00089
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2015
Parcel: 2S110CB13000
Jurisdiction: TIGARD
Site address: 12065 SW AUTUMNVIEW ST
Project: Southview Heights,Lot 18 Subdivision: SOUTH VIEW HEIGHTS Lot: 18
Project Description: Sewer connection for new SF
Contractor: Owner: STONE BRIDGE HOMES NW LLC
4230 GALEWOOD ST, STE 100
LAKE OSWEGO, OR 97035
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/21/2015 $5,100.00
Sewer Inspection-Residential 10/21/2015 $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 $5,135.00
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 su nded for : e the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. hose rules are s; forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a :.' of the rules or direct •uestions
to OU by calling 503.232.19:7 : .:00.332.2344. /
Iss ed By: / /'// I / Permittee Signature: /
Call 503.639.4175 by 7:00 a.m.for the next available inspection '•te.
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.