11755 SW SUMMER CREST DRIVE I
wr .
11755 SW SUMN'.ER CREST DRIVE
i ,
t
N
0
u
v
u
u
I �
W
I �
;3
c/7
�n
I
r
i
Address ,� )tl _ Permit No.�n
Permit charge �-
Owner .__.._.^. —_ Connection fee��
Paid by"�1"'�7"''•e`a� � ,z �ti
TYPE! of Building __ Date connected:
Service Rate-------- Inspection fee iLj�t
Contractor-
Sipe of connection
f' Assess nent Paid by �� . tet , _Date
%
_�_
I
w w
PERMIT TO CO?+;NEC,,T
Tigard Sanitary District
PERMIT 1119 ' 110 DATE —..
IIFR311T IS GIVEN TO - ---- -___--- __-----------
OF
TO CONNECT A —
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT --
THIS PERMIT MUST BE POSTED ON THE DESCR►BED PREMISES UNTIL CON-
NF.C.TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PI,FTED.
PERMIT FEE PAID �.... . -...�...................'TiGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVES
.. Date •----------- -----------�p,,.�;,tendent -"'--_--__.