13235 SW VILLAGE GLENN CIRCLE 13235 SW VILLAGE GLENN CIRCLE
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Address !32 �f � !/ �ry'r'� Permit
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permit charge,_,___,_ -
Connection
Owner
Paid by__. ---
Type of building; �>� Date connected_„ _�T/ --
Service rate —.--
Inspection fee,____. _;2
contractor i --
Paid by____,__,_ —Da te._.Y.r., _
Size of connection "_ _ _ Assessment._.._._P13,i.d_______._
360 � � � �
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PERMIT TO CONNECT 4i
Tigard Sanitary District
PERMIT N�) 137 ti'' DATE !
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PERMIT IS GIVEN TO
OF
TO CO??NECT A ----
1'0 WE SYSTEM OF TTGARD SANITARY DISTRICT
AT
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THIS PERMIT MUST BE 1109TED ON THF,DES('RTBED PRE USES UNTIL CON-
NEC"1' 'N IS MADE AND IFSPECTION OF CONNECTION HAS BEEN COM-
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PERMIT FEE PAID ......:i....'......................TIGARD FANITARY DISTRICT
By LL
CONNECTION INSPECTED AND APPROVED
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