12705 SW 128TH AVENUE 1270:', SW 128TH AVENUE
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Address_ 12705 S.W. 12811 Ave. Permit Noy 1444
Permit charge___
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Owner _ Connection fee_ J7j.0U
Pai.d by_ _�.._ _...
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Type of building Res. Date connected__
Service rate r Inspection fee_ 2 .00 r
Contractor Dale Cnnstriiction Paid by Dale const._ Date_,______
Size of connection 4" Assessment ] aid
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1444 DATE
PEfour is GIVEN TO
OF _---TO CONNECT A '
TO THE SYSTEM OF TIGARD SANITARY DISTRICT _
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF L-ONNECTION HAS BEEN CO11f-
PLETr D,
PERMIT FEE PAID $....... c.......................TFGARD SANITARY DISTRICT
CONVECTION INSPECTED AND APPROVED
— -— Doe -- —giuPerEttei ent