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Permit charge ^�
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Type of Building----- -,. Date connected
Service Rate Inspection fee
Contractor______ Paid by----.Date--
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PERMIT TO CONNECT
Tigard Sanitary Jai.trict
PEPA fTT N° 1310 DATE i t.
PERMIT IS GIVEN TO
OF
TO CONNECT A °
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERM!T MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEZ PAID $..! .,�..�. , ,,TIGIARDSAANNITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
Date --- Superintendent