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Tax Lot 2 SI 2 BA 1500 23-10 North Tigardville Addri
Assessment) 618.25
Lateral -
11-1-61 30.92
& SA thereafter
Address .; �� Permit No.
Name of Occupant—q C )4Q.Ikay Permit charge
Connection fee_ L,s��
Paid by f.tit •�
Date connected_ _----
Type of Building _- -- ----_--- --- Inspection fee _
Serv".ce hatr -._ _ ,G�Gi Paid by -_ Date _
Contractor -- Assessment.,_._ ____ Paid .
Size of connectio❑