11645 SW ANN STREET _ _ __ _ _
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COMMUNITY DEVELOPMENT DEPARTMENT OplooM
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PE('.'LTP'U No.
This permit Is issued subject to the regulations contained in Title 14 .............................
of the TMC, State of Oregon Specialty Cojes zoning regulations P[ (AUPIED INSPET',"T'LONS.
Find all other applIcahle codes and ordinances. and it is hereby
agreed that the work will be done in nccordancp,with thy plans and GAS LINIE.
specifications and it compliance with all applicable codes and 1-1,05T IS DU:Ari
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and sullict.,ntractors shall have current city Al..
business tax permits This permit will expire and become null and
void if work is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has
commi.inced. It shall be the responsibility of the permittee to assure
all required InspeJIons are requested and approved.~
Permittee Signature
6 ,
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVL
Address /i�,-�_, Permi-. No.
Permit charge__,-52 '�,'
Owner_ ,; � �,f..:...._.�._:... Connection fee
Paid by
Type of building �, . Date connectedService rate rate Inspecti.on fee 2/-,- .
Contractor Paid by__ Date
Size of connection Assessment Paid
PERMIT TO C014NECT
Tigard Sanitary District
PERMIT NO
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO TIME SYSTEM OF TIGARD SANITARY DISTRIC"I'
AT
THIS PERMIT MUST BE POSTED ON TIIIB DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $... ................... ........TIGARD SANITARY WSTRICT
By
A�AA.bV� MAAARAAr*P.A/
CONNECTION INSPECTFD AND APPROVED
Dace ------ — -Superintendent __._