HomeMy WebLinkAbout031-252-00431-252-04-
RON SMITH'' _
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THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHOJE 533-0740
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CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: 4 �`j r
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Owner's Name: �- �� > < �t'
Date:
Address:
Acct. No:
A. P. No.: 3
Phone: - .33— 3J .a V
No. Units:
Applicant/Agent: Aj 114
Agents Proof:
Address:
Fees:
Phone:
Application $
Preliminary j� r
Arrearage
Review By: �` Date:
CSA 26
Remarks:
SC -OR
y
1st mo. S.C.
Other
Total Fees rJl.-jz.
Collected By:
Date:
Field Review By:.-1�,W �'%7a� tl's� ._ Date:
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Remarks:
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MONTHLY SERVICE CHARGES WILL --OMMENCE
AUTOMATICALLY UPON:
Date of TID approval of completed building sewer (early connection).
❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, -1974).
❑ 180 days after date above, or o -i date of D.P.W. approval of completed building sewer, which ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TIO, YELLOW - ARPLICANT, PINK - DPW, GOLDENROD - DPW to TID