10040 SW GARRETT STREET i )040 SW GARRETT STREET
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Address-/O 0-g p ,S',r�,� q q p�r T Permit No._ a
Name of Occupant_____ Permit change
------ - ----- -- - Connection fee
- --- - ------— -- - -- Paid
-- - Date connected /
Iyr4 of Building_ Inspection fee
Service Rate_ e----_- Paid by Date
Contractor Ac7sessment- _ Paid
Size of connection
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PERMIT TO CON14ECT
.� Tigard Sanitary District
PERMIT Nj ) 932 DATE
PCrA1IT IS GIVEN TO Y i "�C ,� C A S
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT —` —
ATUj
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADII, AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAIL) $. . . ......-,,,,,„,,,,,......TIGARD SANITARY DISTRICT
By
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CONNECTION INSPECTED AND APPROVED
Date Superintendent