Permit (5) CITY OF TIGARD SEWER CONNECTION PERMIT
�. COMMUNITY DEVELOPMENT Permit#: SWR2019-00282
Date Issued: 10/21/2019
FIC;A R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112BD12000
Jurisdiction: Tigard
Site address: 7620 SW HANSEN LN
Project: Elderberry Ridge,Lot 16 Subdivision: ELDERBERRY RIDGE Lot: 16
Project Description: Sewer connection for new SF.
Contractor: Owner: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PL STE 370
BEAVERTON, OR 97006
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/21/2019 $5,800.00
Sewer Inspection-Residential 10/21/2019 $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 $5,835.00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Special Codes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not starte. ;thin 180 days of issuance, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ado. ed .y the Oregon Utility Notification
Center. Those rules are orth in *AR 952-001-0010, rough OAR 952-001-0090. You may obtain . cop of the rules or direct questions
to OUNC by calling 503.2. ::7 or 1 :10.332.2 4.
Issued By: A Permittee Signature: /
rte.-
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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 of the project.
Approved plans are required on the job site at the time of each inspection.