14620-14630 SW 106TH AVENUE-1 ® � s
14620-30 SW 106TH DRIVE
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1434 DATE _ J
PERMIT IS GIVEN TO .�� '. :.fit ,va_� �J_•-�it .. +t.f
OF
TC CONNECT A r /JiYy �,,/ A SG• �✓
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT Ole
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECfION IS MADE AND INSPECTION OF CONNECTION NAS BEEN COM-
PLETED.
PERMIT FEE PAID $....../..Y L..... ..ty......TIGARD SANITARY DISTRICT
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BY/Pt
CONNECTION INSPECTED AND APPROVED
Date - - - - - Sapfrintendent
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Address 1462o & 30 S.W. 10611 Permit No . 1434
Permit charge
owner Stan Adkins Connection fee 750.0,)
Paid by
Type of b-ailding DuL, Px Date connected _
Service rate—_._ _ Inspection fee 25.00
Contractcr Stan Adki no - Paid by - Date_—_._„—_
Size of connection_. Assessment Paid________
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