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Permit
q CITY OF TIGARD i SEWER CONNECTION PERMIT a �.'. COMMUNITY DEVELOPMENT �� Permit #: SWR2013 00007 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 © Date Issued: 01/29/2013 Parcel: 2S104DB05700 Jurisdiction: Tigard Site address: 13257 SW MAPLECREST CT Project: Maplecrest Lot 4 Subdivision: MAPLECREST Lot: 4 Project Description: Sewer Connection for New SF. 2/4/13, reprinted to record ASI information. Contractor: Owner: RICHARDS, M DALE ADAMS, HEATHER M 12655 SW NORTH DAKOTA TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 01/29/2013 $4,665.00 • Sewer Inspection - Residential 01/29/2013 $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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ose rules - - set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You II - obtain a copy of the rules or direct questions to OU by calling 503.232.. • : 1 ::'.332.2344. ■ Is ued By: 0 02:4/. � ■ Permitter Signature: /au Call 503.639.4175 by 7:00 a.m. for the next available inspec • • n date. This permit card shall be kept in a conspicuous place on the job site • completion of the project. • Approved plans are required on the job site at the time of each inspection. n CITY OF TIGARD SEWER CONNECTION PERMIT i l • • . -,; COMMUNITY DEVELOPMENT Permit #: SWR2013 00007 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013 Parcel: 2S 104 DB05700 Jurisdiction: Tigard Site address: 13257 SW MAPLECREST CT Project: Maplecrest Lot 4 Subdivision: MAPLECREST Lot: 4 Project Description: Sewer Connection for New SF Contractor: Owner: RICHARDS, M DALE ADAMS, HEATHER M 12655 SW NORTH DAKOTA TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 01/29/2013 $4,665.00 Sewer Inspection - Residential 01/29/2013 $35.00 Type of Use: Class of Work: Install Type: Fixture Units: Number of Dwelling Units: 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 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 • ng i. 232.1987 or 1.800.332.2344. Issued B ' / , 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. 1