Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2010 -00004
I dx,ft, 5 13125 SW Hall Blvd., Tigard OR 97223 503539.4171 Date Issued: 01/06/2010
Parcel: 2S111CB01737
Jurisdiction: Tigard
Site address: 10370 SW HOODVIEW DR
Subdivision: HOOD VIEW NO, 2 Lot: 36
Project: Takahashi
Project Description: Connect existing house to sewer service. Reimbursement District fee on 1/6/10.
Owner:
FEES
TAKAHASHI, AKEMI & TETSURO Description Date Amount
10370 SW HOODVIEW DR Sewer Connection Fee 01/06/2010 $3,600.00
TIGARD, OR 97224 Sewer Inspection - Residential 01/06/2010 $35.00
PHONE: 503 - 639 -0862
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: ALT
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 Noti ion Cent . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OUN b ' g 03.246.6699 or 1.800.332.2344. /
Iss d By: AOadoctitile Permittee Signature: ,^ /f� 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.