Permit INr- ��
CITY OF TIGARD SEWER CONNECTION PERMIT
• • COMMUNITY DEVELOPMENT Permit#: SWR2016-00116
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016
Parcel: 2S103CCO2100
Jurisdiction: Tigard
Site address: 12060 SW ROSE VISTA DR
Project: Brien Subdivision: COLONIAL VIEW Lot: 16
Project Description: Connect existing house to sewer service.
Contractor: Owner: BRIEN, KENNETH G&
AMACHER, JUANITA
12060 SW ROSE VISTA DR .
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 04/13/2016 $5,100.00
Sewer Inspection-Residential 04/13/2016 $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 $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 • he rules or dir t questions
to OUNC by callinq_.Q3.232.1987 or 1.800.332.2344.
Issued By:C ./ Permittee Signature: /
—‘""---1---1, _
Call 503.639.4175 by 7:00 a.m.for the next available inspectio .ate.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.