Permit �� CITY OF TIGARD SEWER CONNECTION PERMIT
` ` 2 COMMUNITY DEVELOPMENT Permit #: SWR2011 -00044
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/10/2011
Parcel: 2S112BD01700
Jurisdiction: Tigard
Site address: 15050 SW 79TH AVE
Project: CARLSON Subdivision: DURHAM ACRES Lot: 38
Project Description: Connecting to sewer.
Contractor: Owner: CARLSON, BRUCE & VICKI
15050 SW 79TH AVE
TIGARD, OR 97224
PHONE PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/10/2011 $4,100.00
Sewer Inspection - Residential 03/10/2011 $35.00
Type of Use: SF
Class of Work: ALT
Install Type: 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 -0090. You may obtain a opy of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.
Issued By: Permittee Signature:
Call .03.... • - 5 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr ject.
Approved plans are required on the job site at the time of each inspection.