Permit (193) 4 CITY OF TIGARD SEWER CONNECTION PERMIT
= COMMUNITY DEVELOPMENT Permlts: SWR2015-00173
• s 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/06/2016
Parcel: 1S136AA14300
Jurisdiction: TIGARD
Site address: 10115 SW 67TH AVE
Project: Oak Street Estates,Lot 38 Subdivision: OAK STREET ESTATES Lot: 38
Project Description: New SF.
Contractor: Owner: LENNAR NORTHWEST INC
11870 NE 99TH ST, STE 1170
VANCOUVER,WA 98682
PHONE: PHONE:
FAX
FEES
Description Date Amount
Specifics: Sewer Connection Fee 12/31/2015 $5,100.00
Sewer Inspection-Residential 12/31/2015 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1 j
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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules apnorUdility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtainirect questions
to OUNC by calling 503.232.19 800.332.2344.
Issued By: � -/ � Permiftee Signature:
lXXCall 603.639.4175 by 7:00 a.m.for the next available Inspec on date.
This permit card shall be kept in a conspicuous place on the job site until mpielio
Approved plans are required on the job site at the time of each nspecti