11450 SW 94TH AVENUE 11450 SW 94TH AVENUE
I
t
v
ni
u
.t
Orn
3
O
Ln
I
I
PERMIT TO CONNECT
Tigas-d Sanitary District
PERMIT No 728 DATE ___-a s 0
PERMIT IS GIVEN TO / �- �Ia
OF �;K;1�/.sem a • '��, .... v -- –
TO CONNECT A �•-•RTO THE SYSTEM OF TYGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED. -I u
PERMIT FEE PAID $...... ..........................TIGARD W4ARY DISTIC.CT
By
L'
..�....�
('0NNEF7TION INSPECTED ANO APPROVED \
Date – — ..__ S tendent
Address- --__ 1/ �� �� Pe,mit No.�_ Sf _
Nem% of Occupant "
p Permitcharge
we ,,•
'Connection fee
Paid
- - Date connected_ •-�- / .�( .�
Tyne of Building 11,14--5'/4--'('s,ht,(,(t, Inspection fee _L� <<
� a«
Service %ite_ 'lei Paid by /yE."STtR C� Date.
Contractor r44lfF'r"-1 1410f
10f � N� Assessment--Paid
Size of connection
if