11435 SW GREENBURG ROAD 11435 SW GRECNBURG ROAD
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Address 5:cv- Permit Noo__.,....._1. .� ---
Permit charge____,;,'a�
Owner '" �n Connection fee
Paid by_
Type of building_ _ Date connected 11 `11- IG
Service rate __ inspection fee
Contractor _ Paid by ,Date�,�,__,"`
:size of connection % _ Assessment _pai.d —_„—
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1359 DATED- 3 70
PERMIT IS GIVEN TO
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OF __1_L_$_��_._�:�_�_• � � .,� �'•-' cam- c'
TO CONNECT A -
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MITST BE POSTED ON THE DESCR1BE11 A.rml- 9 UNTIL CON-
NECTION IS MADE: AND INSPECTION OF CO"!ECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $...... ...TIGARD Si',NITARY DISTRICT
CONNI?('TION INSPE:(”PED AND APPROVED
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Date Superintendent