11620 SW TIGARD STREET 11620 SW TIGARD SIPAWT
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PERAT TO CONNECT
Tigard. Sanitary District
PERMIT 111° 1382 DATE
PERMIT IS GIVEN lUy1-
OFTO CONNECT A
TO THE SYSTEM (IV TIGARD SANITARY DISTRICT
AT ------�- ---- ---- - — J -
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECCION IS MADE AND INSPECTION OF CONNECTION HAS Cy-F-M COM-
PLETED.
PERMIT FEE PAID S............... :.a....... _....TIC*Ak/) SANITARY DISTRICT
By
CONNEf'TION INSPECTED AND APPROVED
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- _ --------___--
Date
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MW M p,
Address Permit No. 13k2 I
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Permit charge
owner ��.� l,:cf'.; �.., Connection fee '375'ao
Paid by
Type of building Date connected _
Service rate Inspection fee IV ;
Contractor Paid by Date _
Size of connection �f, � Assessment Paid
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