11845 SW SUMMER CREST DRIVE 11845 SN SUMMER CREST DRIVE
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Add ress�lA.l �:'MM/ .aA E'.i.I._ t Permit No._ZZk— ------ - —
Permit charge .2
Owner _ Connection fee
---- - - Paid by-----
Type of Building. c: Date connected t eo
Service Rate` _ Inspection fee
Contractor Paid hyDa.te�
Size of connection _' Assessment Paid
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PERMIT TO CONNECT
Tigard. Sanitary Diz:,trict
,
PERMIT
N 'U 7 DATE - ---
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THI., PERMIT M;J9T BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADF AND INSPECTION OF CONNECTION HAS BEFN COM-
PLETED.
PERMI f FEE PAID a.....• .............................TIGARD SANIT_RT DISTRICT
By
.2f d
CONNECTION INSPECTED AND APPROVED
to SuFeMntendent