13578 SW PACIFIC HIGHWAY 13'78 SW PACIFIC HIGHWAY
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INSPECTION REQUEST
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INSPECTION TIME . L,.!�h'"' PERMIT INC. ,
DATE: / . /�3 DATE ISSUED
,OWNERS NAME '
ADDRESS . _
n N r R A r T n R --
EST N torp , `,'' .,:c! ]b:►et.yr,, -�
RESUL_ roved C7 upp! „ :d ❑
SKETCH,'
l!;SPECTOR DATE
[NOTE: Attach sup;,.ementoi test unto I,rr t�
Address A r- finn -1awW Permit No ,____Ir.
Permit charge.__.__
Owner C. H- Stearns, Connection
Paid
Type of building Date connected 8/2/71
Service rate Inspection fee— 35.n(]
Contractor Paid by___ Date
Size of connection __42L._________,__ Assessment Pai.d
PERMIT TO CONNECT
Tigard Sanitary District
DATE ;7-- 17/0
PERMIT 1.515
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PFI(MIT IS GIVEN TO (1•
OF 'y�
t
TO CONNECT A _- -- -�.–_ --------
P
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCRIB PREMISES I1NTIL CON•-
NECTION AS MADE AND I}VSPECTION„",,_QQNN .C`rJON HAS BEEN COM-
PLETED. r+ � (� "
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PERMIT FEE PAID ;.. .` r...o�........TIGARD SANITARY D1STIv'CT
�4 By
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CONNECTION INSPECTEL ANC APPROVED
-- --- Date�W�._ -Superintendent _ -