11756 SW SUMMER CREST PLACE SUr1MLR CRI;S'1 PLACE rr
w
Lny
Gl
H
U
H
LO
I
PERMIT TO CONNECT
Tigard Sanitary District
PERMI:'r' N() :1105 DATE
1117:11WT IS GIVEN TO '_.0 �. !
of
TO CONNECT A _ ✓_..-�! '�.: :_
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 1S MADE AND INyPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMfT FEE PAID ....................TIGARD SAYTTARY DISTRICT
By l"
.IWrv�.,hO�Mr�M►1ANAeVArti.�Al4�be MAAIWwA.o�.+.r�.Aswh.+s.rrMA,.�
CONNECTION INSPECTED AND APPROVED
Date --_ - Superintendent
Address �� 7 fi� S C� �, - � ��tel Permit No.
Permit charge o�
Owner Connection
Paid by�j�
Type of Builr'i_:y__ Date connected
Ins fee
Service Pace Inspection _�L-
Contractor � � Co� �x (� Paid
Size of connection_ 4 " Asses3ment-- Paid
� li