11580 SW MANZANITA STREET 11580 SW MANZANITA ST'r,i,ET
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Permit charge_ ______--,------
Connection fee
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Date connected_
Inspection fee __• ---
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1089 DATE
PERMIT IS GIVEN TO4 1...-a .
OF I /' /.. e L
TO CONNECT A
'f
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS. PERMIT MUST BE POSTED ON THE DLIWRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PATI) #..... .... ........f............TIGARD SANITARY DISTRICT
5 0"' /
- By
_rs .
c yz3.
CONNECTION INSPECTED AND APPRGYED
I
IDate Superintendent