HomeMy WebLinkAboutPermit Plumbing 1973-1-2
.
.
,CITY OF SPRINGFIELD
,
APPLICATION AND AGREEMENT FOR SANITARY SEWER LATERAL HOOKUP
Application is hereby made by the undersigned property owner (s) for permis-
sion to connect the following described property to a sanitary sewer lateral line
owned and maintained by the City of Springfield, and I agree to pay a hookup
charge of $4.00 per front foot of the property to be served by such sewer lateral
in lieu of an'assessmentagainst the described property:
Proper~y Description:
, Address
to.
Springfield. Oregon
Lot 9. Block 2. Third Addition EdwardtEitates
"1
Amount of front footage: 80 feet
Sewer hookup charge: ($4.00 per front foot):
SOt @ ~.OO per front feqt .( $320.00
Location of City lateral tap-in:
Length of connecting line:
Type of construction:
Size and ki,nd of pipe:
In accordance with provisions of the Springfield City Code, it is provided
that in the event a san i tary sewer I atera I' shou I d be constructed in the future
which is beneficial to the above property, I further expressly agree that the above
property sha.11 be a,ssessedfor such sewer in prec i se I y the same manner as though
the property were not served qy and hooked to a city sewer, and that the above :>".
$4.00 per front foot hookup charge deposited will be applied to such future assess-
mentfor sewer lateral construction.
"
CITY OF SPRINGFIELD. OREGON:
By:J 4' ~L
~. .
Date: ~_I ~, dJ f
dZ~~:
r/
~
STATE OF OREGON
~ ss
)
'County of Lane
this /(J day of w~_ , 19~ before me,
Public i!l...pd. f.~!' t~ sai&'Co).lpty and State, personally
, 7Y~ Q C~ Jr/-'
known to me to be the identical individual described in and who executed the
within instrument and acknowledged to me that ~ execOted the same freely and
voluntarily.
BElT REMEMBERED, That on
the undersigned, a Notary
appeared the within names
, ..
WlirNESS my hand and seal this day and year last above written.
~r /J .... C c../
/!7 ~ _~., A'c:t.
Notary PuQ/lic
.' J'" I
" .........t l
, \
, "
,-:
~ L /973
t'MyCommission'Expires
'-
, .
--'-=--~ -.-..................-. -'" _. ~ -. .._-.