Permit (77) p CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2015-00197
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016
Parcel: 1 S 136AA13100
Jurisdiction: TIGARD
Site address: 10377 SW 67TH AVE
Project: Oak Street Estates,Lot 26 Subdivision: OAK STREET ESTATES Lot: 26
Project Description: Sewer connection for 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 02/04/2016 $5,100.00
Sewer Inspection-Residential 02/04/2016 $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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy o e _ules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: P rmitX—a
tee Signature:
Call 503.639.4175 :0 a.m.for the next available inspection dat"th
This permit card shall be kept in a conspicuous place on the job site until completject.
Approved plans are required on the job site at the time of each inspection.