Permit i ,, CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2011 -00083
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/17/2011
TIGARD g Parcel: 2S109DA15700
Jurisdiction: Tigard
Site address: 15362 SW GREENRIDGE PL
Project: Arlington Heights No. 3, Lot 76 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 76
Project Description: Sewer connection for new SF.
Contractor: Owner: STONE BRIDGE HOMES
16869 SW 65TH AVE #505
LAKE OSWEGO, OR 97035
PHONE: PHONE: 503 - 387 -7577
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/17/2011 $4,100.00
Sewer Inspection - Residential 06/17/2011 $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 i . -. .. & to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
law. All ork will be done i accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if
work i- suspended for more the 80 says. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Cent- . Those rules are set fo in )AR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to O NC by calli • 503.232.1987 800 3,. 344.
Iss ed By: Permittee Signature:
- T
Call 503.639.4175 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 proj - t.
Approved plans are required on the job site at the time of each inspection.