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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 1094 DATE �. �•!., le r
I'I'RMIT IS GIVEN TO 7 SLI.-?t_lC /{c• __ '
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TO CONNECT :a -•_-- ---_;.�--C------• _._.___. �____�
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS f{EEN COM-
PLETED.
PERMIT FEE PAID $............... ................TIGARD SANITARY DISTRICT
By
wAM./bi► ggr,r.,,w.�
CONNECTION INSPECTED AND APPROVED
----- __-_ Date --- superinten ent
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Address 7(��� .SW 1Az,.c . Permit No. �9y
Permit charge
Owner Connection fee
Paid by
Type of Building Date connected
Service Rate` Inspection fee �Q
Contractori.al� .,�i,�. Paid byd �,�,,,Qt �j3 ,,,;,,�Date
Size of connection `lit Assessment Paid