12090 SW 118TH AVENUE RKWUNUM
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PERMIT TO CONNECT'
Tigard Sanitary District
PERMIT N? 995 DATI's
PERMIT IS GIVEN TO
---------------
or
TO CONNECT A
TO THE SYSTEM OF TICARD SANITARY DISTRICT
AT
THIS PEI.tMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM
PI.ETED.
PERMIT FEE PAID $. . ...............
..............TIGARD SANITARY DISTRICT
+V RM/WVI MAr�M/a.VaP
CONNECTION INSPECTED AND APPROVED
Date � -------_.�_.---------------.._
_ Ruperinteudent
Address / Q f# 141 / �N _ Permit No. 9,7s
Name of Occupant Permit cbarge
Connection fee
Paid by
Date connected
Type of Building Inspection fee
Service Rate_ Paid by Date
Coni:a.itor. Assessment Paid
Size of connection