7920 SW PFAFFLE STREET 7920 SW PFAFFLF STREET
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Address 8000 S.W. Pfaffle Permit No. 4838
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Owner Otto Sorg Connection fee 300
Paid. by _...._ ��.._.�... �.
Type of building Residence Date connected 5-23-73
Service rate 3.00 per month Inspection .fee 25
Contractor Aloha P1►irft?ing Paid by Date
Size of connection 411 Assessment Paid
Address 7920 S.W. I'i'affle street Permit No. 4839
�.�.._ Permit a arge
OwnerDbrmaii Sorg _ Connection fee 300
Paid by
Type of building Pesidence Date connected VA 5-2373 j
Service rate 3.00 .per month
Inspection fee 25
Contractor Aloha Plumbing — Paid by
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Size of connection 4"
Assessment __. paid
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UNIFIED SEWERAGE AGENCY NO. 4839
WASHINGTON COUNTY DATE 5-&T3
CITY
APPLICATION FOR SEWF 1 CONNECTION PERMIT
OWNER:
OWNER'S ADDRcSS: ---- ------- _- - ------- ----- --- - -. _ __
STREET
CITY 8TATE
BUILDING SITE: LOT-_._._____^ BLOCK ____ —___._ ADDITION
TAX LOT NO. _. ___.._—._ ___ TYPE OF OCCUPANCY -wart_.-
ADDRESS
1
DWELLING UNITS ___- -- FIXTURE UNITS ---------
SURCHARGE
--_..._SURCHARGE IF APPLICABLE _-- _ -_ —--------....__-------__.__
PERMIT FEE____ ------. -- INSPECTION FEE --_ ____ TOTAL DEPOSITED ______-_-__-_
(NEW) (EXISTING) BUILDING SEWER SYSTEM -_____._._�i�►�etL------.-_-..--- -------s----
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM
•
LINE SIZE --- ---- _- INSTALLER ------.._.....-_____-• --...__ _ _-_ —_--
RECEIVED BY
(ADEN OR ITS AOENTI
COMMENTS:
Thic Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.