11665 SW 79TH AVENUE-1 w w Aqjpff
11665 SW 79TH AVENUE', ---
1
N
C
C
GJ
d
x
L
O�
M
�n
�D
�O
PERMIT TO CONNECT
Tigard Sanitary .District
PERMIT N9 1109 DATE
PERMIT IS GIVEN TO
OF _ r.
TO CONNECT A
TO THE SYSTEM OF TIGAltD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND I'N'SPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $._ .... .......................TIGARD SANITARY DISTRICT
BY
------- - - ---- - - - - - --- ---- ------------- --
.w�wwMwe�nw
CONNECTION INSPECTED AND 1PPROVED
Date Superintendent
Address--L_ / 5 I"!)_ ?9 dzc Permit No. //())/
p Permit charge
Connection dee
Owner 5[1�
Paid by ,vt.,.
Type of Building` Date connected _
Service Rate Inspection tee
2ontractor Paid by z,.. cJ.t.l ate-3 / f�
Assessment
Sire of connection �/ ._Paid
I