11530 SW TIGARD STREET 11530 SW TIGAPO
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Permit charge_���
Owner � .� Connection fee —�V- oe)
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Type of building ���� _ Date connected9 Ic7
Service rate o Inspection fee 1110
Contractor Paid b
_ Y� _ Date
Size of connection y�� Assessment Paid.
PERMIT TO CONNECT
Tigard Sanilary District
PERMIT No 1281 DATE _
PrRMIT IS GIVEN TO
OF K�
TO CONNECT A
TO THE SYSTEM OF T'GSARD SANITARY DISTRICT
THIS PERMIT MUST BCON-
E POSTX ON THE DESCRIBED
NECTION IS MADE 11ND INSPECTION OF CONNECTION HAS E BEF.NILCOM.
"LETED.
PERMIT FRE PAID �•• ,4%4 . '.....TICARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
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