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Permit CITY OF TIGARD SEWER CONNECTION PERMIT ° • COMMUNITY DEVELOPMENT . • Permit #: SWR2012 -00054 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/05/2012 Parcel: 2S109DA18800 Jurisdiction: Tigard Site address: 12706 SW WILLOW POINT LN Project: Arlington Heights No. 3, Lot 117 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 117 Project Description: Sewer connection for new SF Contractor: Owner: COLUMBIA STATE BANK BY JECK, AL 17800 SE MILL PLAIN BLVD, STE 10 VANCOUVER, WA 98683 PHONE: PHONE: FAX: FEES • Description Date Amount Specifics: Sewer Connection Fee 04/05/2012 $4.500.00 Sewer Inspection - Residential 04/05/2012 $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 $4,535.00 • 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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B Permittee Signature: Call 503.6 • : 1,:00 a.m. for the next available Inspection date. This permit card shall be kept • onsplcuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • CITY OF TIGARD SEWER CONNECTION PERMIT • COMMUNITY DEVELOPMENT / ' Permit #: SWR2012 -00054 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/05/2012 '" Parcel: 2S109DA18800 Jurisdiction: Tigard Site address: 12706 SW WILLOW POINT LN Project: Arlington Heights No. 3, Lot 117 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 117 Project Description: Sewer connection for new SF. 4/27/12, reprinted to correct owner information. Contractor: Owner: STONE BRIDGE HOMES 4230 GALEWOOD ST, STE 100 LAKE OSWEGO, OR 97035 PHONE: PHONE: 503 - 387 -7577 FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 04/05/2012 $4,500.00 Sewer Inspection - Residential 04 /05/2012 $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 $4,535.00 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 rul s are set 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 ing 50 . 32.19 r 1.800.332.2344. Issued Permittee Signature: „ - 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 project • Approved plans are required on the job site at the time of each inspection.