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12535 SW GRANT ,AVENUE
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PERMIT TO CONNECT
Tigard Sanitary District
PET.MIT N? 639 nAT lbw'== 4—
a
PFRRIIT IS GIVEN TOOF
TO CONNECT ATO THE SYSTEM OF TTGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED on TH.,,DESC)tiBED Pr.EMISES UNTIL CON••
NECTION IS MADE AND INSPECTION OF CONNECTIC 4 HAS BEEN COM-
PLF.TE D.
PERMIT FEE PAID $....... ..'.. ..,0.....TIGA111) SANITARY DISTRICT
Fly
CONNECTION M:PECTED AND APPROVED
/ 1
Dates
Tax Lot 2 SI 2. BB 1800 23-1.0 North Tigardville Addn.
Assessment 462.74
..ateral 67 .96
530.70
Paid in full 5-12-61
Address :Z Permit No.--
Name
o. _Name of Occupant - U ",d Pennii charge _ ,D D _
Connection fee �.to-D 0
Paid by 1-2 r
Date connected
Type of Building Inspection fee_.
I-ervi.ce Rate_________ _ _ . U(. Paid by Date 1 —7 1.
Contractor _. Assessment ' Paid
Size of connection