10920 SW MIRA COURT lw amilmANWAR --- �` 0
10920 SW MIRA COUF.T
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Addreen 10>20 S W. Mira Ct. Per colt No. 15bl
Permit charge
0Mmer Conne c tion fee 4o0
Paid by -1al Palmer
Type of building Residence Date connected
Servtce rete 3.00 per month 3nspeetiona fee 25.OG
Contractor Hal Palmer Paid by Hal Palmer Date
Size of connection 4-1 Apsesswent Psid
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PERMIT TO CONNECT
Tigard Sanitary Di.stAct
PERMIT N° 1561 nnTr
PERMIT IE; GIVEN TO " ` Z
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT _
THIS PrRMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL.CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID =...................................TIGARD SANITARY DISTRICT
BT
CONNFCTION INSPECTED AND APPROVED
Date luperWendent