10395 SW MEADOW STREET 10395 SW MEAN STREET
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PERMIT TO CONNECT
Tigard Sanitary District :>
PERMIT N° 934 DATh
11 GIVFN TO
OF J
TO CONNFCT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON TILE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION WAS BEEN COM-
PIXTED,
PERMIT FEE PAID P..... . .........................TI(IA:.D SAVITARY DISTRICT
By
srn.
CONNECTION INSPECTED AND APPROVED
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Address �.�y�,� f/. !/l�Af7�J�� Permit No._��
Name of Occupant_ _ Permit charge
Connection fee--
Paid by
by
- -- - Date connected -!4 --141 -
Type of B�idfn9 - _ _ __--- Inspection fee
Service Rate------ __ _ -- Paid by - Date__
Contractor�_-_-- --..-_- Assessment— - __ Paid -_-
Size of connection