13280 SW ASH DRIVE I
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13280 3W ASH DRIVE
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Address_/-3-'VO .�^ <<' AS fl ZVi/ r Permit No.
Name of Occupant_ Permit charge ,p. to
Connection feeed-
-- --- --- - - Paid by
Date connected C
Type of Buildinci _ fs/Df,•�'' inspection fee___ t�d
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Servicq Rate_--- �'�' ----- ---- Paid by Date
Contractor
Contractor APsesgment Paid
Size of connection-
PERMIT TO CONNECT
City of Tigard
Permit N? 527 DATE
PERMIT IS GIVEN TO
//ry
OF
TO CONNECT A,
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PF.RMlT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID $ CITY OF TIGARD.,,,--
CONNECTION INSPECTED AND APPROVED
Date