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' PERMIT TO
Tigard Sanitary District 3't5 CC
PER .iIT N° 1426 DATE
14
PERMIT IS G).VEN TO
OF ZTO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT Cu �1 f
THIS PERMIT MUST BE POSTED ON THE I E,SCRIBED PREMISES UNT1'u CON-
NE(',TION 18 MADE AND INSPECTION OF 1 ONNECTION HAS BEF:Q COM-
PLETED.
PERMIT FEE PAID $.....-. ,�dt�c:.l?...........TIGARD SANITARY DISTRICT
ov- S of y d`
CONNECTION INSPECTED AND APPROVED
Date Superintendent
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ADDRESS —sSc�� `�"� �._ PERMIT NO.
PERMIT CHARGE
OWNER ______ CONNECTION FEE
PAID BY --
TYPE OF BUILDING c= DATE CONNECTED Cz -S
SERVICE RATE .j m .ti�c� INSPECTION FEE
CONTRACTOR �_� PAID BY _! _ DATE _^
SIZE OF CONNECTION ��� i� ASSESSMENT _ __—__ PAID + _ _