11900 SW BURLCREST DRIVE 1
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11900 SW BURLCREST DRIVE,
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Permit No.
Name of Occupant_________,_____—,--_ Permit charge
Connection fee
Paid
Date connected
Type of Buildij. j------.----.- IwqDection fee
Service Rate Paid by Date
Contractor Assessment
Size of connc ction
i
PEPMiT TO CONNECT
City of Tigard
Permit No 857 DATE :V 4,(_-_-_-_
PERMIT IS OIVEN To-_.alA.iz
TO CONNECT A
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PERMIT MUST of POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETFO.
PERMIT FEE PAID CITY OF TIGARD
By. zu
CONNECTION INSPECTED AND APPROVED
Date _ —Sup*rinfandont