11620 SW NORTH DAKOTA STREET 11620 SW NORTH DAKOTA STREET
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AddressM Le-) 'Oermi t No.
Permit charge
owner Connection fee 2,j ,o –
Paid by
Type of Building Date connected
Service Rate Inspection fee
Contractor— Paid by_ Date
Size of connection Assessment --Paid
PER-F ,'IT TO CONNECT
Tigard Sanitary District
PERMIT N? 1184 DATE
PERMIT IS GIVEN TO
or
TO CONNECT A---)L
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST OF POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ..........TIGARD SANITARY DISTRICT
tj — --
By
CONNECTION INSPECTED AND APPROVED
Superintendent
Date 4�ierI