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Permit CITY OF TIGARD SEWER CONNECTION PERMIT • r'` COMMUNITY DEVELOPMENT Permit #: SWR2011 -00065 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/08/2011 Parcel: 2S110CB08000 Jurisdiction: Tigard Site address: 12433 SW AUTUMNVIEW ST Project: Mountain View Estates, Lot 5 Subdivision: MOUNTAIN VIEW ESTATES Lot: 5 Project Description: Sewer connection for new SF Contractor: Owner: JT ROTH CONSTRUCTION INC 12600 SW 72ND TIGARD, OR 97223 PHONE: PHONE: 503 - 639 -2639 FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 06/08/2011 $4,100.00 Sewer Inspection - Residential 06/08/2011 $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 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 th • *AR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 !!7 or 1.800.332.2344 4 111111111kk Issued By: �. �/ Permittee Signature: Call 503x63• 7:00 a.m. for the next available inspection date. This permit card shall .e kept in a conspicuous place on the job site until completion of the pr.'-ct. Approved plans are required on the job site at the time of each inspection.