10025 SW JOHNSON STREET 10025 SW JOHNSON STREET
i
1
u
C
O
C
O
ti
3
Ln
.n
N
O
O
PERMIT TO CONNECT
Tigard Sanitary District
PE RMIT N? 635 DATE "•�✓i •_/< __
PER311T IS GIVEN TO
OF
(' w
TO CONNECT A
TO THE SYSTEM OF TIGARD SAN*TAV.T DISTRICT
AT
/ � +J
THIS PERMIT MUST BE PORTED ON THE DESCRIBED'PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ....... '...................
...TIGARD SANITARY DISTRICT
/ ,
By .���
CONNECTION INSPECTED AND APPROVED
Date �� pe endent
A6i
(� ri,,1.,�, ermit No.
Address I p 0 7. "' C)O _
Permit charge
Name of Occupant
Connection fee_ -L V d
I
Paid by_
_�— Date connected._ 22 __
Inspection --
Type ,.f Building
C)6) Paid by
Service Rate ---
Asaesf mer" Paid
Cuntractor —--i - -
_--
Size of connection
it � .. Is1 •� we �. w �,
N
I
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 tho 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 becom,a delinquent.
I fully understand 1-- at all unpaid sew, r service charges become a lier. upon the
property served as stipulated in O. R. S. 22,.1.220.
Connections to the District's system must be made by bonded contractors and/or
bonded and licensed plumbers.
�/ -owner
At"'PJVFD BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
I
I
Y
1