9100 SW INEZ STREET 9100 SW INGZ STREET
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Addr,:.,ss i'i c�«! r� ---_ '-'ermit
Permit charge '.7 e< -
Owner & „,siQ,,j __ Connection fee a o -
Paid by
Type of Building yC = Date connected
Service Rate Inspection fee
Contractor
Paiu by____ Date
Size of connection y',V Assessment Paid
-
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT M 12442 PA7'`' 7/7/'
PFnMIT IS GIVEN TO
c�. I
— OF — —
TO CONNECT A _ -- ------ ---TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT --
THIS^PERMIT MUST BE POSTED ON THE DESCRI� . PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONN1P TION HAS BEEN COM-
PLETED.
PE:MIT FEE PAID $...... .............TIGARD SANITARY DISTRICT
By . ..,r.
CONNECTION INSPECTED AND APPROVED
--------6uperintendent T--—