10420 SW MEADOW STREET r
10420 SW MEADOW STREET
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 992 DATE _ . I .. I+
PERWAT IS 161VEN TO �-1
TO CONNECT A I ! �,lJ''
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST RI: POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ;....- ......_............TIGARD SAI .TARY DISTRICT
'I-,- +r
CONNEm'ON INSPECTED AND APPROVED
Superintendent
11
Ara dress ��A DD�r/ Permit No.
Name of Occupant. Permit charge
Connection fee_Z
Paid by
Date connec'40
Type of Building _ ' __- Inspection fee__10__ _
Service Rate— Paid by -----_--_Date--------
Contractor _.__.... Asseaement -_Paid__-
Size of conuection "