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Tax Lot 2 SI 2 BD 200 23-10 Ncrth Tigardvi.11e Addn
Assessment 2560 -P4
Paid in Full 6-16-61
Address -� �G� � , �` Permit No.
Name of Occupant, + 't Permit charge
Connection fee__
Paid by --
Date connected---_.---_
'Type of Building._22t<� t��_I � Inspection fee_- --_._----- ----- ---- --
Service Rate _ _-_ - Paid by ,__-__,--- __ Dete
Contractor _ — Asaessrient_,°�.:_( _Paid_ --..
Size of connection