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11805 SW GAARDE STREET 11805 SW GAARDE STREET H W H W 3 Ln v1 O 00 _ Receipt4p-?frv� SEXIER PERMIT N? 20170 Uf fied Sewerage Agency DATE 9�24�79 ot. Washington County CITY OF T.iga rd _ OWNER : Paul & Linda Anderson _ PHONE :_6.20-7742 OWNER ' S ADDRESS: TYPE OF INSTALLATION: 2 BUILDING SEWER L] BUILDING SEWER APID SIDE SIWER TYPE. OF OCCUPANCY: ❑ NEW ED SIV LE FAMILY COMMERCIAL. ❑ EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL FIXTURE UNITS ._..__ DWELLING UNITS__ _ ADDRESS OF STRUCTURE : 1.1805 SW Gaarde Street PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND REGULATIONS OF THE UNIFIED SFWERAGF AGENCY. WHEN CALLING FOR INSPECTIO14 , PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE- HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILT_ BE FORFEITED SHOULD EXPIRATION OCCUR . FEES: PERMIT FEE $_ ._25. 00 CONNECTION CHARGE fl_ n SIDE SEWER INSTALLATION W _ _-- Penny Liebertz _ ISSUED BY OTHER 'TOTAL.. $ 325. 00 9/24/79____ U DAYS OF THE APDL ICAN'L DATE I�.Jt1'J'E GATE, SEW, ER SFRM, CLl P 33T J4-00E ','1111 135-G14 F01 TV" No i t AF)DRF_SS OF SIRUCTURf_= 11.805 SLI Gnarde Sl.rnot: TAX MAP 2_ 15 3LD TAX l_nT 3701 SYSTEM _ F nno Creek— LOT BLOCK OF Hazeltree _ DWH 9/24/79 9/279 APPREIVED BY DA1 F ISS . f D EY DATE D. U . ' S 1 RL-MARKS Septic tank to be pumpted and filled With sand, as per state rode.