Permit (50) CITY OF TIGARD SEWER CONNECTION PERMIT
41
IN a . COMMUNITY DEVELOPMENT Permit#: SWR2016-00091
T t G RID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2016
Parcel: 2S109DB08400
Jurisdiction: Tigard
Site address: 13137 SW BLACK WALNUT ST
Project: Summit Ridge No.5,Lot 152 Subdivision: SUMMIT RIDGE NO.5 Lot: 152
Project Description: Sewer connection for new SF
Contractor: Owner: DR HORTON INC
4380 SW MACADAM AVE
PORTLAND,OR 97239
PHONE: PHONE:
FAX:
FEES
Description Date Amount
.
Specifics: Sewer Connection Fee 05/02/2016 $5,100.00
Sewer Inspection-Residential 05/02/2016 $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 cop of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.3 .- . 1
Issued By: Svs�� . Permittee Signature:
'yam Call 5Z 175 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 the project.
Approved plans are required on the job site at the time of each inspection.