10405 SW JOHNSON STREET 10405 SW JOEiNSON STREE`,
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT NY 778 DATE
PFRIIIIT IS GIVEN TO
TO CONNECT Ate'
TO THE SYSTEM OT TIGARD SANITARY DISTRICT
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THIS PERMIT MUST RE POSTED ON THE DESCMDED PREMISES UNTIL t'7N-
NFCTION I.`i MADE AND INSPECTION OF CONNECTION HAS BEEN COl'7-
FLETED.
PERMIT NEF. PAIL) .. .......................TIGARD SANITARY DISTRICT
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CONNEC"CION INSPECTED AND APPROVED
Date Superintendent
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Address.A/C G >`j/, Permit
Name of Occupant__ �r ���. ���'[ y Permit charge ,,?
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Connection fee
--- ---- - - Paid byc
_.�_ ---- -- Date connected / 6.5 _
Type of $» )3ir. /lE S! 'a
-U---•. _ .__.._- Inspection fee_
Service Rate- �� �'�
/ -- _- Paid by_��Git'__Dated f r.
Contractor ,7A/!)£S ��/�/O C __ Assessment
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Size of connection Al