11675 SW TIGARD STREET .11675 SW `I'IGARD 3MPE Y'
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HERMIT TO CONNECT
Tigard. Sanitary Distric c
PERMIT N9 1389 DATE
PERMIT IS GIVEN TO
OF __--
TO CONNECT A ---
TO THE SYSTEM OF TIGARD CANITARY DISTRICT
AT —.—
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PRF MISES UNTIL CO V-
NE('TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COT I-
PIXTED.
PERMIT FEE PAID E.... ....... ...'i1G-+!�^ '"iANiiARYDISTRICT
................
By
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CONNE 110N INSPECT1.9 AND APPROVED
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Date Eupertntendent
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Addr.:8s //���s 5��,.,.
�1, . � � � �, Permit No .
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Permit charge
Owner Z 7 , ,� Connection fee7.y.,;,,°_',
��l°t • `��'! /'`r �c �:/Cc c.,rlc�►c Paid by
Type of building Tc----2 Date connected -
Service rate Inspection fee
Contractor Paid by� Dates_
Size of connection � AssessmentPaid
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