11830 SW SUMMER CREST DRIVE SW SUMMER CREST DRIVE
PERMIT TO CONNECT /
Tigard. Sanitary District
PERMIT N? 1363 DATE // 6 " 7 C
PERMIT IS GIVEN TO
OF
r
TO CONNECT A
TO THE SYSTEM OF TIGARD aANITABY DISTRICT
AT
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT RTE PAID ..—TIGARD SANITARY DISTRTT
CONNECTION INSPECTED AND APPROVED
Date Superintendent
i
1
gill
Permit No.
'Address
Permit charge
Owners �c �l , � �� __ Conne:ti.on fee
M_
Paid by_
Type of building �'c.._ . Date connec Leri_
Service rate Inspection fee
__ � ---
Contractor Paid by__ Date
Size of connection l'' Assessment ____PaA