Permit
`q CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit SWR2010-00017
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/24/2010
Parcel: 2S 109AB 12300
Jurisdiction: Tigard
Site address: 14248 SW ALPINE CREST WAY
Subdivision: ALPINE VIEW Lot: 4
Project: Alpine View
Project Description: Sewer connection for new SF.
FEES
Owner:
COLUMBIA RIVER BANK Description Date Amount
17800 SE MILL PLAIN BLVD #100 Sewer Connection Fee 02/24/2010 $3,600.00
VANCOUVER, WA 98683 Sewer Inspection - Residential 02/24/2010 $35.00
PHONE:
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 Notifi ion Ce 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 estion503 246 6699 or 1.800.332.2344.
Issue Y.
PermitteeSignature:
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.