11700 SW TIGARD STREET I /00 SW 'VIGARD_-., J ,'
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PERMIT TO CONNECT
Tige-d Sanitary Distri-t
PG1vA1L N91230
PFRA117 'S GIVEN TO
OF -- — -- -- _ -- -- ':
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT f '
TH*S PERMIT MIST 13F POSTED (7N THE DESCRIBED PREMISES CNTIL CON-
NECTION IS MADI', AND INSPECTION OF CONNECTION HAS BERN COM-
PLETED.
PEV'.#IIT FEE PAID TIGARD SANITARY DISTRICT
By
2. 1
CONNECTION INSPIel'TED AND APTROVED
uatc - Supw inhndent
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Address Permit
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��� � �� M Perm1t
Permit charge_
Owner_ �/��� Connection fee e�
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Paid by
Type of Building Date connected
Service Ra�e� Inspection fee_ /d
Contractor— Paid by Date
Size of connection ��� Assessment Y ___._-�—�
Paid
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