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Service Rate (,C,0 -js Inspection fee___ /G)`11'
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Size of connection i ' Assessment Paid
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PERMIT TO CONN ECT
Tigard Sanitary District
PERMIT N9 1311 DATE _tl
PERMIT 1S GIVEN TOOF
TO CONNECT A _ ------- - - -
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
DEI;CRIBED
CON-
UNTI
NES
ICTION PERMIT MADE AND NSPECT 0I•, OFF CONNECTION rNASESREEN LCOM-
PLETED.
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PERMIT FEE PAID 1�..:2.�`'.• ...... • •TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND API'IEOVED
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