11555 SW 88TH AVENUE-1 I
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11555 SW Ef1' H AVENUE
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PERMIT TO CONNECT � I
Tigard Sanitary District
PERMIT N9 t?1 y
PERMIT IS GIVEN TO
OF _—� �.._ .6 ?i2 r;"a►. �r" 'f/;�.�'�7 GGA
TO (TONNE:T A
TO THE SYSTEM OF TIGARD SANITARY D 1STRIC—
AT
THIS PERMIT MUST RE POSTED ON THE DE,9CRIBED PREMISES UNTIL CON••
NECPION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FFE PAID ........ . .f..............1'IGARll SANITARY DiSTl11(:T
By
CONNECTION INSPECTED AND APPROVED
Date Supertntem ent
y— �
I
Address j_�yy �• , ;"Y� �� Permit No.
Permit chargee _ _
`, i Connection fee
Owner VK ��4 �,•� - £"*`
i'
Paid by
Type of BuildingDate connected
Service Rate Insp-crion fee
Contractor
Faid by Date _
— "'
Size of connection ,�
Assessment Paid
Glover Blefins
Construction Pd - 3/21/62 $250.00
Engr - $11.7 .00
Supt - 77_OC
X144.00 Refund $106.00
Address /J_tiJ' �GJ. � --- Per,r.it
Name of OcruFant_ Fe-,mit
Connection fee____ -----
Paid
Date connected -
Type of Building -__- Inspection fee
Service Rate --- --___-- __ Paid by Date
Contractor. -_ Assesement_ Paid
Size of connection