11680 SW NORTH DAKOTA STREET 11680 SW NORTH DAKOTA STREET
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Address Permit No.
Permit charge
Owner Connection fee
Paid by
Type of Building Date connected
Service Rate Inspection fee
Contractor Paid by _Date
Size of connection Assessment` Paid
PERMIT O CONNECT
Tigard Sanitary District n
PERMIT N9 1279 DATE
PFR311T IS GIVEN TO
OF
TO CONNECT A ,I
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT.—/ Lam'THIS PERMIT MUST BE P014TED ON THE DFSCRIBF.D PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ;. .. ... �. .:...............TIGARD SANITARY DISTRICT
G
JL By. �C L
^...
CONNI?C CION INSPECTED AND APPROVED
Date Superintendent