11860 SW 121ST AVENUE u:uw uuuu -j
11860 sw 121ST AVENUE
: w
J
i
e,
v 1�
r �
j
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT' N9 1192 DATE
I'FR31IT 18 GIVEN TO —
r'.
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT J
THIS PERMIT MUST BE POSTED ON THE DFSCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT /FEE PAID S.,« ............................TIGARD SANITARY DISTRICT
w y al l
By --�_._—� -------
�%y e
CCt4NEC ION INSPECTED AND APPROVED
---_-__-- Date
I
I
I
i
i
�- 7D
Address Permit No,_�i'>�
Permit charge _ Y
Owner U '' � Connection fee
Paid by
Type of buildinir Date connected
Service rate (,c;, Inspection fee
Contractor Paid by Date
Size of connection 's Assessment Paid
l/ ,CSL' ' ✓tin.x'�"iJ
40,i