11890 SW NORTH DAKOTA STREET 11890 SW NORTH DAKOTA STREET
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, A__--- Permit No. /D Q
Name of Occupant.-_._-_`_____ Permit charge
Connection fee 2S'O a,
_...---- — - - -- Paid byAA,&,,.) * p-_ AA k3
Date connected 00- 3 /-
Type
0-3 /-Type of Building It--'C'_S_ - - Inspection fee_rQ _p
Service Rate___. Paid by _ Date--
Contractor Assessment Paid
Size of connection _'�7
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? 1008 DATE
PFW%fIT IS GIVEN TO
TO CONNEVe A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PEnmIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION I,, MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $....... ................TIGARD SANITARY DISTRICT
1 0 By
'76-3
CONNECTION INSPECTED AND APPROVED
Date- �~� Superintendent r ��