12035 SW BURLHEIGHTS STREET nEMMUNFULIFF I -��flk
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12035 SW BURLHElGHTS STREET
Permit No.
Name o! C-wupant_ Permit charge
Connection fee -2SO
Paid by-AkkiiEN Pi-,�na
Dole connected
Type of Building Instec-tion fee_JTS°
Service Rate Paid by
Contractor AoseFsznent--- Paid
.,----
Si7e if connection
PERMIT TO CONNECT
Tigard Sanitary Disr ict
PERMIT N? 1006
PERMIT IS GIVEN TO
OF
TO CONNECT A_ ------
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
s
THIS PERMIT MUST BF POSTED ON THE DESCRIBi:D PREMISES UNTIL CON-
NFCTION IS MADE AND INSPiCTIUN lit' CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE SAIL' $.........s7:........................TIGARD SANITARY DISTRICT
o sx.a 89 --- , w' --
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CONNECTION INSPECTED AND APPROVED
Rate - 9upeeln'endent
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