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12285 SW 124TH AVENUE
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Address 12245 S.W. 124th Permit No
Permit charge
Owner Connection fee 4Uo_Uow_
F i i d by_Vance Lee r
Type of building Residence Date connected
Service rate 3•U0 per njoath _ Inspection fee 25.00_
Contractor. Vane Lee _ Paid by_ same —Date
Size of connection 411 Assessment—_ .1-aid�
✓ D � T�
PERMIT TO CONNECT ),-fl �4
Tigard Sanitary DiSLri.ct
PERMIT N? 1525 DATE
PFR311T IS GIVEN TO ,
OF
'TO CONNECT A
TJ THE SYSTEM OF TIGARD SANITARY DISTRICT -
AT
THIS PERMIT MUST BE POSTED ON E DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION 4 CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID �.. . •,...... ....._..........TIGARD FANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date-- ------ -- —�__ 8upevintendent_____-..- .