9969 SW WALNUT STREET 9969 SW WALNUT AVENUE _.
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PERMIT TO CONNECT
`rigard Sanitary District
PER.IA.17 ���t' 6 7 6 DiA9'E�l ��. _ - t .
PERMIT IS GI%lVN TO
OF ,...
TO CONNECTA,
TO THE SYSTEM SOF TIGARD SANITARY DISTRICT
AT
THIS PERMIT :MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NTECTIJN IS MADE AND INSPEC'C1ON OF CONNECTION HA4 BEEN COW
PLETED.
PERMIT FEE PAID $_.. :...........................TIGARD SANITARY LISTRICT
By
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CONNE( PION INSPECTED AND APPROVED
Date ;UPC! 4,n e,it'
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Permit No.�
Address -x
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Name of Occupant Permit charge. 0"2
Connection foe
Paid b-
Date connected
Type of Building f 41" Inspection fea-
V
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Service Rate S Paid by Date
I;e ,/ /J'&A�,Al j
Contractor., _AJ It Assessment- Paid
Size 61 connection N—q
APPLICATION FOR OSEWER SERVICE
The undersigned agrees, in consideration of the sewer service connection by the
Tigard Sanitary District, to abide by and comply with the o,•dinances, 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.
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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 contractors and, or
bonded and licensed plumbers. ,
- �—� Owner' ^
APPROVED BY
S periutendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St
Tigard, Or-igon
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