11737 SW 88TH AVENUE SW 68TH AVENUE
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 103'p? DATZ . 62—
PE1311T IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF T;GARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DF9CRTv"A?D PRXMIt3E-Qj UNTIL CON-
NECTION IS MADE AND INSPECTION 01' CONNECTION HAS RF"N COM-
I'LL,TED.
PERMIT FEE PAID ,J.....................-........TIGARD SA NITA'tY DISTRICT
S, By 4.4-
IS, o-e
CONNECTION INSPECTED AND APPROVED
Date Superintendent
Address J 7
Permit No. IC 12—
NampofOccup-art_____------- Permit charge 2--- -_ - -
Connection fee j4SLf_,!!!!_
Paid by
Data connected
Type 3f buildinge"___ Insp.3ction fee_/_.Q—=--__._._..----..-
Service I.idte-------- P&id by Date—_
Contraclor Assessment__ —Paid--
`iiE of connection