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.12770 SW MARIE COURT
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PERMIT TO CONNECT
":`igarcl Sanitary District (;� I
PERMIT N° 12 5 8 DATE
PERMIT IS GIVEN TO ,.ly �--
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OF
TO CONNECT A ._--
TO'.CITE SYSTEM OF TIGARD SANITARY DIS rRICT
ATIg.. _•
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NEC'I'ION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID .................IIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date Superintendent
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Address— ;a i'7b �i�� . Perms No.
Permit charge
Connection fee
Owner ' • �< ` '
Paid
Type of Building____ "J?A.J. _ Date connected `a
Service Rate —_ Inspection fee . �> `�`' _
Paid by_—.—Date
Contractor. �..,___.._ -----
_.__ ,_ Assessment � _--Pai.d
Size of connection ____/ ----
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