Permit n CITY OF TIGARD SEWER CONNECTION PERMIT
.111 COMMUNITY DEVELOPMENT Permit #: SWR2012 00157
Date Issued: 08/16/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109DA14300
Jurisdiction: Tigard
Site address: 12603 SW MOUNT VISTA CT
Project: Arlington Heights No. 3, Lot 62 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 62
Project Description: Sewer connection for new SF
Contractor: Owner: STONE BRIDGE HOMES
4230 GALEWOOD ST SUITE #100
LAKE OSWEGO, OR 97035
PHONE: PHONE: 503 - 387 -7577
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 08/16/2012 $4,665.00
Sewer Inspection - Residential 08/16/2012 $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 $4,700.00
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 sus ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. ose ru 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 OUN by calling 503. 32.1987 or 1.800.332.2344.
Issue By: 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.