10540 10550 SW CANTERBURY LANE vl
0
m
0
G un
E
? tj
rt
rD
M
Q'
i C
rf
,C
r
i
I
10540 & 10550 SW CANTERBURY LANE
J
C
P_0.@x Zl 7
CITY OF -rIG ARD PWMBINC LU25 SW Wu MY&
Appl"nb must hold ter, "walion to o m&d a pilrrl ft PERMIT 6316-Q.75
73
business or rnum lie property owner/operaux not h out:ude help.
a ttlprrserM to,�vnbI �;/,4 PinK Pennii Nn. .� .
Addts/wol
c
_I�
Jots lel - 1, ps ti t t?1 aIAN--------' C; 14 T
Tia map.No. _
Address
FIXTURES
LAI Block B4txtMelon ---- ------ ---
Sink 7.50
Or r1anN /� Lava"- -- — --- 7.50 --
_ �t c'►rGs(.�.1ri rub or TL61&w)wer Comb -!- 7.50
NO"AI
Stxrwer Or* _ 7.50
Owner 5y// to zip Wndw Clow ------- — 7.50
Dishwasher - 7 50
1° Garbage Disposal --- -- 750 - -
Name WaO*V Machine- ---'-- - ---- 7.5r, _
FkxxDrarn -- - - -- -- 7.50 - ---
ess Water Healer - - --- — .750
o-")vo ` L `+- ' Laundry Wtcm Tray - -- - 7.50
Occupant /Stan ZIP
--
C`�� urinal — -- 7-50 -
Name —� > O ltw Fneurae(Specify) 7.50
ZlZ
M&OV Address Pico
Contractor /State � • 1 ZIP - 7.50
�- �1J WSCELLANEOUS
City Bija Tax �T--___-r— r T--
Sev+Mia.A".100 1500
t# s _ _
(Rasrdenbal) r Water Servios t st 100 -- -- - 20.00- --
1 hereby w*rxrwtedpe Mesa 1 to"rata!osis application.MnM eM Irma ambn Wa/er Servm ea.AdM"' - ---- 1500 -
piven is cmreet,Mut I am mi#ll.ari,vW MN State&tlLder's Board,and aho Slarm d Pain Oram 101 100' 30.00
have Is Sus#Pkxnbkw lmiie that the r>lrn*ws glvsn am am, Owl all ---------- ---- -- -
ttk►nbrtig work wlf be dorsa Mr acardrsc#with a 01I p-+*xu of Oke Storm i Pyn Drain Addti.1_011 15.00_
i Dn Revised S1,11I Chapi"447 and OW and app&Abkl Dodos and M+af
no help wM be#nKrloyed unless k mnsed under ORS On (11 asempl Iran Mobile Flome SparA 25 00-
Sc,vu regla radon.Pftww 17h'e reaaan below). Back Flow Prevenikm
HOMEOWNERS- I hereby oerefy Meal 1 am to owner of fns progeny do- DwAm err An04NAuion Device 7750
Kited above,M whit7h locafon 1 pnopoes to make a pkxTb ft knMah'ation W Arry Trap or Waal Piot
Orly 00m use and this property is not bolnp oonalrueied bra raw.lean or rant. C nneatad to a POws 7.50
Gari 9saka_ _ 7.50 -
kup.of rider ntWnbi V -- 40.00 Per Hr
- - - ---_— _- NWUly P&WItogiled ktspedil" - 40.00 Per Hr.
AMsr of Pkar *V wI
an Sdp. - 15.00 min_
AUT}IORILED SK)NAT RE CMM New Oft,or Bund.Addlfan _� 25.00 rnin
Bmin pain,5i mle � �— --
Demor be worts naw O addition[) Membon❑ r+apair l dup11 - 15.00
----
rvft"use ol
M�?ORi1L 17
:lam
11'itA1�ntatf Oaootttfa ttritA ttrd traidf wet*w•aortanwtiart aalwMr r raM opr►
DIU 111101114d
tttlfln�04rtNitirf OMtflatrtAM dr stoaRbfUlMgrdMl m ebtieLOartatl►�
a IMrtwd ter 1123 r9gnt hi err r Ansa ells►waSa Iti olMrwtina�l r
l
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? 1433 DATE 4 - G 7 �
PrRMIT IS Q } ,
ell r
TO CONNECT A._,q � AJ. ,- C
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTII.CON-
NEVFION IS MADE AND INSPECTION OF CONNECTION HAS BEEN cow
PLE;TIED.
PERMIT FEF. PAID :......i~- j�� p��,,,..•pIGARD SANITARY DISTRICT
BY r
1
CONNECTION INSPEM*'-D AND AMOVED
�V
• Date Supeclntendeat i _.
I
Address 105An & 50 -W- C3nLex.bury Permit
Permit charge________
Owner Stan Adkins Connection
Paid by,.
_
Type of building �)u;j fex__ Date connected
Service rate
Inspection fee__
Contractor__ Stan Adkjjjg__ _ Paid by Date '
Size of connection__ 4'' Assessment Paid