11820 SW MANZANITA STREET 11820 SW MANZANITA STREET
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Address, 142,0 Permit No.
Name of Occupant_ _ Permit charge
Connection fee
Paid by
__ -—_--_--__—_- Date connected
Type of Building__________ —_ Inspection fee___
Service Rate_`._ Paid by _ Date
Contractor Assessment Paid
Si¢e of connection
r4igard
ERMIT TO CONNECT
Sanitary District
PERMIT N° 1054 DATE _._--
PERMIT IS GIVEN ZA
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TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
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{ THIS PERMIT MiTgT BE POSTED ON THE DERCRIBED PREMISES UNTIL CON-
NECTION TION IS MAD;-,,' AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $...._ _..........................TIGARD SANITARY DI91..(CT
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+CONNECTION INSPECTED AND APPROVED
Date Superintendent