10500 SW JOHNSON COURT 10500 SW JOHNSON COURT
J
I
u
v
G
0
G
0
0
Ln
0
i
PERMIT TO CONNECT
Tigard. unitary District
N° 766 DATE��A,4,Vt-f-
PERMIT
PERMIT Ila GIVEN TO
OF If
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT 7M?ST
I l l L'��"! '4 r �- ---------
I'Nl9 PERMIT BE POSTED ON THE ESCRiBF.D PREMISES UNTILCON-
NECTION IS MADE AND INSPECTION OF CONNECTION IIAS BEEN
COM-
PLETED.
PERMIT FEE PAID $..1?..............................
T1lI9IcR1 Ayflf9'1iR1E. ►18T711E1T`
By
hA1•MN
CONNECTION INSPECTED AND APPROVED
- — llate
Address 11/-SIN CI- Permit No.
Name of Occupant_JZ�� hie n 4, Permit charge
Connection fee _
Paid by �• ��/ISO c..iE_-
------ Date connected__
Type of Building `s/DC�/��� _ Inspection feed' r —
�. / �¢
Service Hate. r _- Paid by Date
Contractor. �Y-d2t `0"� �d�e _-- Assessments-_--.--_----Paid_ ---
Size of connection_