12200 SW 126TH AVENUE-1 1
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12200 SW 126TH AVENUE
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Addres -12200 S.W. 12uth l--- Permit
Permit
Owner Mr. & Mrs. Richard L. Willis Connection .fee 400.o0___,_, .__.r__
Paid by_,_,M________
Tyne of building Residence Date connected 4-25-72
Service rate 3.00 per month Inspection fee._2�.Qo ._.__.__._.w..._._
C- atractor_Dale ConstructionPaid by Dale Const. __DatP.3=28�2,__
Size of connection—_ 4+____,...____.._.. Assessment.____�M—Paa.d___.Y _ ---
PERMIT TO CONNECT
'l ig and Sanitary District
PERMIT V 105 5 DATE
PERMIT IS GIVEN TO JL_
OF ---
TO CONNECT A
TO THE SYSTEM OF 9;VIARD SANITARY DISTRICT
AT _ -.e"A-, A_ ne,
THIS PERMIT MUST RE POSTED ON THE DE.9CRIREF TIRF511SES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
i'1.11111T FEE PAID A ....:......................TIGARD SANITARY DISTRICT
RY
r.
CONNECTION INSPECTED AND APPROVED