Permit (204) 11‘11CITY OF TIGARD SEWER CONNECTION PERMIT
a, . COMMUNITY DEVELOPMENT Permit#: SWR2018 00026
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 01/22/2018
TIGARD 9
Parcel: 2S 103 BA00800
Jurisdiction: Tigard
Site address: 11865 SW WALNUT ST
Project: McCoy Subdivision: None Lot: None
Project Description: Sewer connection for existing residence. No sewer reimbursement due per Johnny Gish.
Contractor: Owner: MCCOY, MARY P
11865 SW WALNUT ST
TIGARD, OR 97223
PHONE: PHONE: 503-515-5547
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/22/2018 $5,500.00
Sewer Inspection-Residential 01/22/2018 $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 503.232.1 7 or 1 800.33` 344.
Issued By: ' / �i , � � -It1 ee Signature: `` ��
Call 503.639.4175 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 o the proj t.
Approved plans are required on the job site at the time of each inspection.