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Permit CITY OF TIGARD SEWER CONNECTION PERMIT 1111 C OMMUNITY DEVELOPMENT Permit #: SWR2008-00022 13125 SW Hall Blvd. Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011 TIGARD Parcel: 2S102DCO5600 Jurisdiction: TIG Site address: 13874 SW HALCYON TER Project: GERTZ HOMES AT EDGEWOOD Subdivision: Lot: Project Description: New SF. Contractor: Owner: GERTZ CONSTRUCTION COMPANY, INC. 19200 SW 46TH AVE TUALATIN, OR 97062 PHONE: PHONE: 503 - 692 -3390 FAX: FEES Description Date Amount Specifics: [SWUSA] Sewer Connection Fee 12/10/2010 $2,800.00 [SWINSP] Sewer Inspection Fee 12/10/2010 $35.00 Type of Use: SF Class of Work: NEW Install Type: LTPSWR Fixture Units: Number of Dwelling Units: 1.0 Total $2,835.00 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 may obtain a copy of the rules or direct questions to OUNC by calling 503.2 1987 or 1.800.332.2344. Issued By: 1 Permittee Signature: Call 5030 by 7:00 a.m. for the next available inspection ate. This permit card shall be kep 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.