10345 SW JOHNSON STREET 10345 SW JOHNSON STRGGT
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PFR
Ti(jard Sanitary District
PERMIT M 779 DATE _ --
PERMIT IS GIVEN TO
OF
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TO CON''
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
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millt9 PERMIT MUST ND PO"ED op INSPECTION OF CONNECT ON FRIAR SBEEN UNTIL COM
rFCTION IB MADE A
kFTED.
.. ...TIGARD SANITARY DISTRICT
PERMIT FEE PAID �.. .... /B7 k
CONNECTION INSPFGRFD AND APIROVF.D
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Date
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Address / / '�' J. �N� ,,7��1 0� T' Permit No.
Name of Occupant � `� �c�u'� Permit charge c�
Connection fee
Paid by —)i(c/C C'o1u/i.
Date connected
Type of Buildings s r� Inspection fee
Service Rate s ° _ Paid by—7' ,AloD<c Date
Contractor_ .ryr`jnAcai�tJ Aasesament-___ Paid
Size of connection _!�