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-_ - Al T1. G��/�` Permii No,
Name of Occupant________ !, Permit char e Z.
- - - -- Connection fee 1J O
--------_.___---.---,.—_.__.___ -�_--__-- Paid by- --
- - - - - Date connected
Type of Building
Inspection fee
Service Rate Paid by
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Contractor Assessment-
Size
Size of connection
AF
]PERMIT TO CONNEk
Tigard Sanitary District 7-2
PERMIT N9 1022 DATE
PERMIT IS GIVEN TO i
OF i
TO CONNECT A '.;
TO THE OF TIGARD SANITARY DISTRICT
AT
TINS PEL".SIT MUST RE POSTED ON THE DESCRIBED PREMISES I.'N'I'LI,t:ON-
NECTION IS MADE AND INSPECTION OF CONNECTWN HAS BEEN COM-
PLET: *.
PERMIT FEE PALO .... .............................TIGARD SANITARY DISTRICT
By
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CONNECTION INSPECTED AND APPROVED
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Supeirintend'e'nt 1....—