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PERMIT TO CONNECT
City of 'Tigard
Permit 1!10 X65 DATE �_ �,r_
PERMIT IS GIVEN TO_-SCI OF
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TO CONNE( : A. ' !�
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL. CON.
NECT;ON IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID $ � / CITY OF TIGARD
CONNECTION INSPECTD AND APPROVED
-Date Suparinte' dM} �" y
I
dd
Address '�� ., �• '------ = rmit No.
Nam, of Occi;.pant Permit charge__.__
Connection fee
Paid
Date connected
Typo of n.ii:diaq — --- Inspection
Servico mate Paid b Date
Co.itractor Assessment Pain
Size of connection
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 y
APPROVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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