Permit `''' CITY OF TIGARD SEWER CONNECTION PERMIT
'< COMMUNITY DEVELOPMENT Permit #: SWR2009 -00118
Date Issued: 10/27/2009
T,1 1kb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103BA00104
Jurisdiction: Tigard
Site address: 11890 SW ANN ST
Subdivision: LERON HEIGHTS Lot: 4
Project: Hutchinson
Project Description: Connect existing SF to sewer. Install up to 100' sewer service.
FEES
Owner:
•
HUTCHISON, PERRY C Description Date Amount
11890 SW ANN ST Sewer Connection Fee 10/26/2009 $3,600.00
TIGARD, OR 97223 Sewer Inspection - Residential 10/26/2009 $35.00
PHONE:
Contractor:
APOLLO DRAIN & ROOTER SERVICE
2208 NW BIRDS DALE #8
GRESHAM, OR 97030
PHONE: 503 - 239 -8801
FAX: 503- 669 -9568
Type of Use: SF
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,635.00
Required Items and Reports (Conditions)
1 Prcl Eng PD. REIMBURSEMENT DISTRICT
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 ork -will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifi tion Center. Those rule , e set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct estion to OUNC by > mg 5“.2699 or 1.800.332.2344.
Issu d By: ,I �� 4 Permittee Sign• ure: r y j
Al Call 503.639.4175 by 7:00 a.m. for an inspection that business .ay.
This permit card shall be kept 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.