11965 SW SUMMER CREST DRIVE 11965 SW SUMMER CREST DRIVE
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 '11P4 DATE -- -
PERM/I�' IS GIVTN TO _ ;`/ ! �-- —r1 �. .,f C rt✓
or
TO CONNECT A C-
""1 THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST RE POSTED ON THE DESCRIPED PREM19W UNTIL CON-
NF('TION IS BADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMI T FEE PAID 11- ...TIGAHD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date Superintendent
Address L �,u �),,� . Permit No. �(�y
Permit charge J'�P-
Owner•^ Connection
"�"fe c _s
Paid by _Y"4_.
Type of Building-.- ___ Date connected
Ser-ice Rate _ inspection fei Ij
' fl �Q,, � _ Paid b _
C o n t r a c i�•.a�..�.��E���`-1 .... y •�- fi,.,_.�r..���e �'
Size of connection _ Assessment Paid