Permit (129) CITY OF TIGARD SEWER CONNECTION PERMIT
llm COMMUNITY DEVELOPMENT Permit#: SWR2017-00359
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
Parcel: 2 S 109AC07500
Jurisdiction: Tigard
Site address: 13266 SW MADDIE LN
Project: Madeline Heights, Lot 13 Subdivision: MADELINE HEIGHTS Lot: 13
Project Description: New SF.
Contractor: Owner: SAGE BUILT HOMES LLC
1815 NW 169TH PL STE 1040
BEAVERTON, OR 97006
PHONE: PHONE: 360-258-7900
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 11/30/2017 $5,500.00
Sewer Inspection-Residential 11/30/2017 $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 o - rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / /L Permittee Signature: - �
Call 503.639.4175 by 7:00 a.m.for the next available inspection d.te.
This permit card shall be kept in a conspicuous place on the job site until comple '•n of th- project.
Approved plans are required on the job site at the time of each inspectio .