Permit (2) CITY OF TIGARD SEWER CONNECTION PERMIT
Permit#: SWR2019-00330
COMMUNITY DEVELOPMENT Date Issued: 01/21/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S103CA00311
Jurisdiction: Tigard
Site address: 13194 SW 121ST AVE
Project: Birch Mill Estates, Lot 6 Subdivision: BIRCH MILL SUBDIVISION Lot:
Project Description: Sewer connection for new SF.
Contractor: Owner: LF121 LLC
5285 MEADOWS RD, STE 171
LAKE OSWEGO, OR 97035
PHONE:
PHONE: 503-657-3402
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/21/2020 $5,800.00
Sewer Inspection-Residential 01/21/2020 $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. 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 ma obtain a copy of the es or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344
Issued By: Permittee Signature:
all 03.639.4175 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.