Permit CITY OF TIGARD SEWER CONNECTION PERMIT
' COMMUNITY DEVELOPMENT Permit #: SWR2013 00117
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 06/05/2013
Parcel: 1 S 135DB05504
Jurisdiction: Tigard
Site address: 11350 SW 95TH AVE
Project: Kreisberg Subdivision: THOMAS TERRACE Lot: 5 -6
Project Description: Connect existing house to sewer service. No existing lateral on property, work in public right -of -way to be done
under PFI2013- 00018.
Contractor: Owner: KREISBERG, LOUIS & ELIZABETH J
11350 SW 95TH AVE
TIGARD, OR 97223
PHONE: PHONE
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/05/2013 $4,665.00
Sewer Inspection - Residential 06/05/2013 $35.00
Type of Use: SF
Class of Work: ALT
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 Those - are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a py of the rules or direct questions
to OUNC by ding 503.2 198 •r 1 800.332 2344
Issued : / / .4,4// Permittee Signature: t
Call 503.639.4175 by 7:00 a.m. for the next available inspection dat
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.