11875 SW GAARDE STREET 11875 SW GAARDE STREET
I
H
W
H
W
3
sn
Ln
n
I I
Receipt #4026
SEWER PERMIT N ., z, s
3 ;, �.
UniFed w
�Sewerage Agency
of Washington County CITY OF Ti qa rJ DATE
OW'IER : Herman & Antonia Porter �^ PHONE : 639--0895
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
0 BUILDING SEWER L BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑ NEW ® SINGLE FAMILY ❑ COMME;,C_AL
�(_] EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS _ DWELLING UNITS 1
ADDRESS OF STRUCTURE : _ 11875 SL! Gaarde reed_—
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WH;-N CALLING FOR INSPECTION.
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
.EXPIRATION OCCUR .
FEES:
PERMIT FEE $— 25. 00
CONNECTION CHARGE 300. 00
SIDE SEWER INSTALLATION , Penny Liebertz
OTHER
ISSUED BY
TOTAL s325. 00
APPLICANT DAT[
;,...c►�
SERVICE
ti°Ittl Will FOR THIS. �E WE R Jam' ElIT
N"06 nADDRESS OF STRUCTI IPI- 11875 SW_Gaarde Street
TAX MAP 2S1 3CU TAX LOT 3800 ~
SYSTEM F_anno Creek
LOT ----BLOCK i_ O F
OWH 9224 79_ __ �
APPROVED BY DAIS -� ISS UQ BY DATE
D. U. ' S _ 1 REMA'tKS Septic tank oto be �um��c1_ and f; t t e+d ,i h
4per State Cuoe. � "