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Permit q CITY OF TIGARD SEWER CONNECTION PERMIT • COMMUNITY DEVELOPMENT a y /6 Permit 9: SWR2015-00142 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2015 Parcel: 2S1060001500 Jurisdiction: TIGARD Site address: 17191 SW HOLLY RIDGE LN Project: River Terrace Northwest,Lot 18 Subdivision: RIVER TERRACE NORTHWEST Lot: 18 Project Description: Sewer connection for new SF-Model Home.. 2/4/2016: REPRINT permit to change address from 17192 to 17191. Contractor: Owner: POLYGON WLH, LLC 109 E 13TH STREET VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 12/01/2015 $5,100.00 Type of Use: SF Sewer Inspection-Residential 12/01/2015 $35.00 Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $5,135.00 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 50Y.232.1987 or 1.800.332.2344. Issued By: 4Permittee 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. 111.- CITY OF TIGARD SEWER CONNECTION PERMIT g '; COMMUNITY DEVELOPMENT Permit#: SWR2015-00142 TitrARI� 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2015 Parcel: 2S1060001500 Jurisdiction: TIGARD Site address: 17192 SW HOLLY RIDGE LN Project: River Terrace Northwest, Lot 18 Subdivision: RIVER TERRACE NORTHWEST Lot: 18 Project Description: Sewer connection for new SF-Model Home Contractor: Owner: POLYGON WLH, LLC 109 E 13TH STREET VANCOUVER,WA 98660 PHONE: PHONE: 360-695-7700 FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 12/01/2015 $5,100.00 Sewer Inspection-Residential 12/01/2015 $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 $5,135.00 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 calli - I . 2.1987 or 1.800.332.2344. Issued 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.