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12270 SW BELL COURT 'iti
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Address %1y-;P761 Sc iI / .r'1' �: Permit No.
Permit charge_,2—
Own e Connection fee
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Paj.d by__._._._.._.._.__._ _. ._.. ....__.__.
Type of building Date connected — „1
Service rate �, ;'/'� Inspection fee_
Contractor _ _ _ Paid by__ Da 1.e
Size of connection Assessments_— PaLd
PERMIT TO C',',ONNEC T ,;, .s-r ✓��
Tigard. Sanitary District
PERMIT N° 1287 DATE �i i t& `f --
PERMIT IS GIVEN TO � it," �"t.-�i�•�v
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OF
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TO CONNECT A
TO THE SYSTEM OF TIGARD AANITARY DISTRICT
AT ! '7C
THIS PERMIT MUST BE POgTED ON THE DE,gCRIDED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID 5.....`!!...y....................TIGARD SANITARY DISTRICT
By 4 f—
w�MMw��I.M AiAMiAMAI�
CONNE(710N INSPECTED AND APIPROVED
Date Superintendent