Permit CITY OF T71IGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2017-00356
T[GARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/27/2017
Parcel: 2S103CC00700
Jurisdiction: Tigard
Site address: 12075 SW ROSE VISTA DR
Project: SMART Subdivision: COLONIAL VIEW Lot: 2
Project Description: Sewer connection for new SF.
Contractor: Owner: SMART, DAVID&JERI
14051 SW 155TH TER
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 11/21/2017
$5,500.00
Sewer Inspection-Residential 11/21/2017 $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 $5,535.00
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 of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.3"2.2344.
Issued By: u` / Permittee Signature: --� /
Call 503.639.4175 by 7:00 a.m.for the next available inspection da >
This permit card shall be kept in a conspicuous place on the job site until co letion of the project.
Approved plans are required on the job site at the time of each inspection.