12355 SW 124TH AVENUE i! 41 L.4,Li 41k JI..J L.J' UJ,0Lv Li LSI .
12355 SW 124THI AVENUE
•r
Ln
Ln
Ln
fn
CN
AN
A
Y.!
1
h .
w
n
ti
'9!
r
• "
I
t
I,
s
i
Address 1.2355 S.W. 12411 Ave. Permit No. 2463
T'errr i t charge
Owner_ wa:- yanap- T,pp- Connection fee
Paid by
Type of building__ FFG_ Date connected g�ii1Z]
Service rate _ Inspection fee 2r.;_oc,
Contractor V:4 of, T pr Paid by Date
Size of connection 411 _^ Assessment Paid
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° ]. 4 6 3 DATE
PERMIT IS GIVEN TO _
or
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DIATRIC7
AT
THIS PERMIT dITST BE F jSTED ON THE DESCRIBED PREMISES I?NTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ; .... 1.....?...................TIGARD SANITARY DISTRICT
BE
- - ---- ---- - --- - - - - - -
CONNECTION INSPECTED AND APPROVED
--_-___ - Date -^` Superintendent