12685 SW KAREN STREET 1.2685 SW KAREN STREET _
1
u
G
01
H
3
00
V
ILn
k_n
..........
z
5�v�-1
zC7
0
Address 42!21,57 Permit No. 1-309
Permit charge ?`"° _
Owner y �,�,x, ,� Connection fee 1voele _
Paid by
Type of buildir. xr''�, Date connected
Service rate /�z, - gip Inspection feezlQ
Contractor Paid by _Date_
Size of connection_ y � Assessment Paid
i
I
1
9
PERMIT T4 CONNECT x; .
Tigard Sanitary District
i
PERMIT N° 1309 DA'1 E
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
�s, w
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 18 MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID La...hc...I!. "`` TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
as
Date Buperink-ndent