11450 SW 90TH AVENUE e - 11450 SW 90TH AVE14UE `
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Address S.L_� j� --___ Permit No. �d -
Name of Occupant_—,---- Permit charge `
Connection fee —
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Faid by
Date tonne::ted_ - �'�' 2'
Type of BuildingInspection f'ee_ �C
Service Rat9 it uv `_ Paid by LS Date 2 - L
Contractor \` �C " ' ---. Assessment__� 7+-E- PaidY-
Size of connection!
APPLICATION FOR SEWER SERVICE
The undersigned agrees, in consideration c. .ae sewer serviuk! connection by the
Tigard Sanitary District, to abide by and comply with the ordinances, zogulations end 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 chargee become a lien upon thq
property served as stipulated in O. R. S. 224.220.
Conne,:4ons to the District's system must be made by bonded contractors and/or
bonded and licensed plumbers. #� _.
Owner
.APPROVED BY
r>
uperintendent
TIGA.RD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
AL
PERMIT TO CONNEC�
Tigard Sanitary District
PERMIT Nj ) 688 DATE ° e
PERMIT IS GIVEN TO '1
OF _�� ism ✓J �/�./�.-__ .♦_y t.._.cY�f� (,�w�'� -----
TO Cd'_oNECT A
TO TIKE SYSTEM OF T'IGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $...... ..... ................„...TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date�Y_ ---- Superintendent