12566 SW MAIN STREET 12566 SW MAIN STREET
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Address Z2_��l� s,-�1/��i�s.-„L Permit
Name of Occupant
1 Permit charge_ e7 C.)
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( Connection fee /•��•7�
Pard by
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Type of Building_- i" Inspection fee -01 d�
Service Hate _ 3, 0 U ) % e /
- Paid by . " '` Dats
Contractor Assessment_ Paid _
Size of connection
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PERMIT TO CONNECT
City of Tigard �`
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Permit No X18
DATE
PERMIT IS GIVEN
TO CONNECT A s
TO T14E SYSTEM OF CITY OF TIGARD
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THIS PERMIT MUS1' BE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID _ ...
. .,CITY OF TIGARD
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CONNECTION INSPECTED AND APPROVED
Date Superintendent