12720 SW BELL COURT I .
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12720 SW BBIL COURT
Address1. c; 1 -,i CD,r: _ Permit No./� �/
Permit charge!
Owner x� __ Connection fee L:97
Paid
Type of building - A Date connected.
Inspection fee le`�`�
Service .rata P _
Contractor ri Paid by__ Dat—t,_
Size of connection y" Assessment. —Paid
PERMjr COO 4NECT T X11
Tigard Sanitary District
PERMIT V' 1:;9 2' TATE
,
PFIIMI'r IS G1vrN TO '• -� -Z ,F,
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OF
TO CONNECT A
TO THE STSTEM OF TIVARD SANITART DISTRICT
THIS PERMIT MUST BE r, TED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND - ,-jeECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAIR �....r�..4:..1..................TIGARD 9ANITARV DISTRICT
By-- - - - - - - - ---- - --- - -
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CONNECTION INSPECTF.O AND APPROVES
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