10275 SW MEADOW STREET 10275 SW MEAT-)OW STREET
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PERMIT TO CONNEIrT
City of Tigard �y
Permit Ny 874 DATE
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PERMIT IS GIVt i TO
OF —
TO CONNECT A-- I'I
TO THE SYSTEM OF CITY OF TIGARD
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THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL COW
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID S --..---CITY OF TIOARD
BY.
CONNECTION INSPECTED AND APPROVED
02
's-
Date
Date Soperintgndent
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AddressP 1 J -fly!\ Permit No. 7
Name of Occupant—__ Permit charge
Connection
Paid
---- ---- -- ----- -- Date connected __ . --
Tyne of Building---__.-- --------_---------___-_ Inspection fee
Service Rate_ __ _—_ Paid by Date-__-
Contractor ----�, Assessmeni_-__--------.__...._-__--Paid ----
Size of connection