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CITYOFTIIFARD
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COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd..P.O.Box 233b7,Tlgurd.omgo,-i9T223.(503)639-4J75 PPIM PMT.NO E190 I At
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NO 20869
This permit is issued subject to tho regulations contained In Title 14
zoning regulations 1:)F.:QLJ I I-W 1' 1-N PEI::T'T NS
of the TMC, State of Oregon Specialty Codes.
and all other applicable codes and ordinances, and It Is hereby
agreed that the work will be done in accordance with the plans and
P09 V A
HI M
sp.c0ications and in compliance with all applicable codes and
ordinances. rhe issuance of this permit does not waive reatilctive
covenants. Contractor and subcontractors shall have current city 1 .T NAL
business tax permits This permit will expire and bacnme null and
void it work a not started within 180 days,or it work is suspended or
Rbandonec for a period of 180 days any time after work har,
commerical,' It shall be the responsibility of the parmitlee to assure
all required Inspections are requested and approved
Permittee Signature
Issued By: H114 ks; 4 . —
SEPARATE
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SEPARATE PERMTSPEQUIRED FOR %YORK OTHER THAN DESCRIBED ABOVE
PERMIT TO CONNECT
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� '� Tigard Sanitary District H ,
PERMIT N? - 14 31 DATH J71
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PERMIT IS GIVEN TO
OF
TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT �
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETFD.
PF.RMI'iC FEE PAID $............:.....................TICARD SANITARY DISTRICT
CONNE(7110N INSPECTED AND APPROVED
Date Superintendent
�1 v
•
Address Permit Noy
�V �--?�
Permit charge
Owner Connection fee -!300
U• �
Paid by_____r__
Type of building—,r„ _ Date connected _�_?.�__..___.___�
Service rate Inspection fee X50`. _._.._ ._.
Contractor— Paid by_ _ Date
Size of connectionL/ _ Assessment
4