11685 SW BURLCREST DRIVE a
is
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11685DRIVE
Address/am4 4 9 Permit No. 9W/ 9
Name of Occupant Permit charge r
Connection tee
Paid by
Date connected k ' / 9– ` 7
Type of Building — Inspectiou
Service Rate Paid by
Contractor, Assessm6-it—____._!Paid
!:;.-e of connection _. _
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PERMIT TO CONNECT �.
Tigard. Sa--iitary District
PERMIT N9 '969 1)ITS
PERMIT IS GIVEN TO _'�I I ti c .�+ C` \ �� �q�• . `. .�4
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT � j � t 1. ,, ?
THIS PERMIT MUST IlE POSTED '.IN THE DESCRIBED PREMISES UN-IL CON-
NECTION IN MADE. AND INSPECTION OF CONNECTION HAS REEN CObi-
PLETED.
J�
PERMIT FEE PAID $...................................TIGARD SANITARY rASTRICT
By
CONNECTION INSPECTED AND APPROVED
A, Grp f
- ---Date ���_ Superintendent ��