Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2010 -00156
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2011
Parcel: 1S125DC07900
Jurisdiction: Tigard
Site address: 7012 SW ASH CREEK CT
Project: Ash Creek Estates, Lot 12 Subdivision: ASH CREEK ESTATES Lot: 12
Project Description: Sewer connection for new SF.
Contractor: Owner: ASH CREEK PROPERTIES LLC
12655 SW NORTH DAKOTA ST
TIGARD, OR 97223
PHONE: PHONE: 503 - 780 -4375
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/26/2011 $4,100.00
Sewer Inspection - Residential 01/26/2011 $35.00
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 w� k –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 s6spended fo ore the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center( Those rules are et 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 callin 503.232.1 87 o 1.800.332.2344.
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Iss�ed By: � Permittee Signature: ` Ad
Call 503.639.4175 by 7:00 a.m. for the next available inspe. ion date.
This permit card shall be kept in a conspicuous place on the job site until completion . — I - project.
Approved plans are required on the job site at the time of each inspection.