11455 SW LOMITA AVENUE 11455 S'.V LOMITA AVENUE
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J,TY OF TIGPf'C`
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Address !1` ~ Permit No. 7
Name of OccupaPermit charge r
Connection fee $02 Y69 d v
Paid by
Date ccnnected
Type of Building�� 9�� q�i1 /�_. Inspection fee
Service Rate 4 � G _._ Paid by L`�K Date
Contractor-c- i, Assessment V— Paid
Size of connection__" —
'CIT'Y OF TIGARD
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 bo ed co tractors and/or
bonded and licensed plumbers.
Owner
APPROVED BY
Su erintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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0 - PERMIT TO YONNECT
C/TY /,),Clal? l)
Tigard Sanitary District
PERMIT N° 714 DATE I e-29 a
r?-,MIT IS GIVEN TO
OF
TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRI!Wn PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLET?D.
C/rY cf r.,fai q AID
PERMIT WEE PAID $ ,y)(................TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date Superintendent