Permit (11) CITY OF TIGARD SEWER CONNECTION PERMIT
's•
COMMUNITY DEVELOPMENT WPermit#: SR2016-00327
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2016
T I[ A I.r, g Parcel: 2S109DB01701
Jurisdiction: TIGARD
Site address: 13100 SW SUMMIT RIDGE ST
Project: Zeider Annexation Subdivision: Lot:
Project Description: Sewer connection for existing house.
Contractor: Owner: JANET ZEIDER
13100 SW SUMMIT RIDGE ST
PHONE: PHONE: 503-620-2428
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/03/2016 $5,300.00
Sewer Inspection-Residential 10/03/2016 $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 $5,335.00
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. s are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy 'f the rules or direct questions
to OU by calling 503T'. .1• • .::0.332.223444.
I ued By: � �i2� 11 Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection .ate.
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.