11700 SW 90TH AVENUE _ • ° v —
11700 SW 90TH AVENUE —
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PERM11 TO C0NNE'"_".T
Tigard Sanitary District
PERMIT lit° 643 k
PFRNIIT IS GIVEN TO
�.-
TO CONNECT A +
TO THE SYSTEM CIP TIGARD SINITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED. )
PWMIT FEE PAID $.�!. .�e( .........TIGARD SANITARY DISTRICT
C NNE ION INSPECTED AND APPROVED
Date superinty ent
Address Permit No.
Name of Occupant_-- _ Permit charg•e
_ ----- i , ,-r4 -«-(^ Connection feeri1f'�-
Paid by
_ ---- - -W----- Date connected___
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Tvpe of Building Inspection fee J� —
Service Rate Paid by/ �,( _Date 6 6
Contracto Assessment
----- -
Size a! ronneciion £
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