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Address Itja o "f/0 4► Permit No. _
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Name of Occupant � Permit charge
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----- - --_ Connection fee
— _ _---- ---- --- Paid by �� 111
Date connected 2
Type of Building ---- Inspection fee
Service Rate_,_ __ Paid by
Contractor _ JVD �' Assessment
Paid___,____
Size of connection 00,j �___
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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
properly 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.
---_ --- ---�—
APPROVED BY Owner
Superintendent -- -� —
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TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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Address ,� /Sf�O Lf/, wPermit No.
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Fame of O(.^.:gant _ Permit charge
Connection fee_— U v
- -- --- — ------- -- Paid by ✓C.cr ,��¢ ���
Date connected
Type of Building— ,(� J(
/u:'vu Inspection fee /0 .Zl�,___
Service Rate_ `- Paid by Date ��l '/ 9
/� f
CoWractor 4 � �4 1, ` �_ J)4v,14 Assessment Paid.
Size of connection �'� ~1
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 presen►ly 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 ccntractors and/or
bonded and licensed plumLers.
Owner
APPROVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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PERMIT TO CONNECT
Tigard Sanitary District
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a PERMIT N° 71.2 DATE
PFR311T IS GIVEN 1'O r �r rvCJl�( `� ��••
OF �0•
TO CONNECT A__,&_
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT �3 Q U rJ U►J ( (- -7t j--!. C74-1.0 THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 1S MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED. v
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PERMIT FEE PAID $.... ......w�.....................TIGARD SANITARY DISTRICT
By
----------------- - - -
CONNECTION INSPECTED AND APPROVED
Date Fftpa tendeat