Permit (128) CITY OF TIGARD SEWER CONNECTION PERMIT
." COMMUNITY DEVELOPMENTIN
Permit#: SWR2017-00370
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/06/2017
T E -Ll Parcel: 2S109AC07800
Jurisdiction: Tigard
Site address: 13322 SW MADDIE LN
Project: Madeline Heights,Lot 16 Subdivision: MADELINE HEIGHTS Lot: 16
Project Description: Sewer connection for new SF.
Contractor: Owner: LENNAR NW INC.
11807 NE 99TH STREET#1170
VANCOUVER,WA 98682
PHONE:
PHONE: 360-258-7900
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 12/06/2017 $5,500.00
Sewer Inspection-Residential 12/06/2017 $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 $5,535.00
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 • Utili Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of th-s o dire t questions
to OUNC by calling 503. .1987 or 1.800.332.2344. /
Issued By: Permittee Signature: .�
-‘ i9 .ceetiZt ----- ...MI >°';'
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 completio • e project.
Approved plans are required on the job site at the time of each inspection.