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Permit CITY OF TIGARD SEWER CONNECTION PERMIT 's COMMUNITY DEVELOPMENT Permit #: SWR2010 -00106 1 A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2010 Parcel: 2S109AB13600 Jurisdiction: Tigard Site address: 14443 SW FORAN TER Subdivision: Alpine View Lot: 17 Project: Alpine View Project Description: Sewer connection for new SF FEES Owner: WEST HILLS DEVELOPMENT Description Date Amount 735 SW 158TH Sewer Connection Fee 08/25/2010 $4,100.00 BEAVERTON, OR 97006 Sewer Inspection - Residential 08/25/2010 $35.00 PHONE: 503 - 641 -7342 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 $4,135.00 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 quest'- o 0 1 1. .y c- g 503.246.6699 or 1.800.332.2344. Issued B • , 1 /, Permittee Signature: / r 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.