SWR1967-1056 PERMIT TO CONNECT
Tigard Sanitary District
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PERMIT N° 1056 DATE 7 7
PERMIT IS GIVEN TO AL I - 3674 --- 6)
_
OF 61 J
TO CONNECT A 41
TO" THE SYSTEM OF TIGARD, SANITARY DISTRiCT
1,1747 fk H IA)
AT
THIS PERMIT MUST BE POSTED ON THE'D4CRIBED PREMISES UNTIL CON-
, NECTION IS MADE AND INSPECTION OF ,CONNECTION HAS BEEN COM,
pLETED.
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PERMIT FEE ,PAID $ TIGARD ,SANIT-ARY DISTRICT
4f By /afl:
.242 . Zass.".0..*4..•• • .eftoe."0.04 . -
CONNECTION INSPECTED AND 'APPROVED
Date `Sim e rintend ent '
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Address // 74' 7f �1/ le4 ill, Permit No. / 40 -c
Name of Occupant Permit charge
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- Connection fee �. Sc
Paid by
Date connected
Type of Building Inspection fee /O m
Service Rate Paid by Date
Contractor Assessment Paid
Size of connection d'
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APPLICATION FOR SEWER SERVICE
The undersigned agrees, in consideration of the sewer service connection by the
Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
posed from time to time when due and before such charges become delinquent.
I fully understand that all unpaid sewer service charges become a lien upon the
property served as stipulated in O. R. S. 224.220.
Connections to the District's system must be made by bonded contractors and /or
bonded and licensed plumbers.
Owner
APPROVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St. -
Tigard, Oregon