10455 SW MEADOW STREET 10455 SW MEADOW STREET
I
i
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 991 DATE
PER3IIT IS GIVEN TO
OF
-.w.
TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST PE POSTED ON THE DESCRIBED PREMISES UNTIL CON
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
VF.RMIT FEE PAID $...... ............ .TIGARD SANITARY DISTh�':'T
By
} — ----—
.ew. w.�wwMwr
CONFECTION INSPECTED AND APPROVFD
Date Superintendent
• /i� L
Address Permit No.
Name of Occupant__- _
---- Permit charge --
-- -- ---- - - ----- Connection fee O
__----- -- --- - Paid b
- _ Date connected
Type of Building / p Inspection fee--c -
Service Rate �.-_._..- Paid by - -------Aate_.�
Contractor
- --- Assessment Paid
Size of connection_