9940 SW JOHNSON STREET 9940 SW JOHNSON STREET
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PERMIT TO CONNECT
Tigard Sanitary :istrict
PERMIT N? 6511 DATE - -s
PERMIT IS GIVEN TO i
TO CONNFCr A L/
TO THE S"STf;M OF TIGARD SANITART DISTRICT
AT
THUS PL'RMIT MUST BE PORTED ON AIIE DESCRIBED PRVMISES UNTIL CON-
NECTtaN IS MAIZE AND INSPECTION OF C^`::;.-.:'BION HAS BEEN COM-
PLETED. //�� rr,,��
PERMIT FF.£, PAID $_.1..2......4r...`�.....TIGARD SANITART DIS'T'RICT
ItY
CONNECPION INSPECTED AND APrAOV,FD
Date Sup ndent
1
Tax Lot 2 SI 2 BB 1400 23•-10 North Tigar-dville Addn
Assessment 5'3 . 19
Lateral 67.06
592.25
11-1-t31 29.62 !
& SA thereafter
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Ad aress. Permit No._ (o
Nan:e of Occupant `-1L0Permit charge_..��U 0 1114
----
------ Connection fee__jV 0
Paid by
- Date connected
Type of Bu414co
irg o_Q' �_ iL`f' Inspoction feat
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Service Rate _ �C( ' Paid by —Date
Gntractor �r]�ly- -r �--
-- - _- _ Assessment_.�,,'2.�9Z_Paid
Size of connection
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APPLICATION FOR SEWER SERVICE
The undersigned agrees, in consideration of the sewer service connection by the
Tigan.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 charge, become delinquent.
I fully understand that all unpaid sewer service charges become a lien upon the
property served as stipulated in O. R. IS, 224.22.0.
Connections to the Distri-t's system must be made by bonded contractors and/or
bonded and licensed plu:ubers.
Owner
APP"nVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commei JJ St. I
Tigard, Oregon
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