Permit
CITY OF TIGARD SEWER CONNECTION PERMIT
n
COMMUNITY DEVELOPMENT Permit#: SWR2009-00132
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/07/2010
Parcel: 2S104BB09900
Jurisdiction: Tigard
Site address: 14093 SW WALNUT CREEK WAY
Subdivision: Lot: 0
Project: Walnut Creek
Project Description: Sewer connection for new SF
FEES
Owner:
MATRIX DEVELOPMENT CORP Description Date Amount
12755 SW 69TH AVE #100 Sewer Connection Fee 01/07/2010 $3,600.00
TIGARD, OR 97223 Sewer Inspection - Residential 01/07/2010 $35.00
PHONE: 503-620-8080
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,635.00
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 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.3/u132~►.233444.
Issued By: ~I ~JV V Permittee Signature:
y
del
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.