11575 11577 SW LOMITA AVENUE ■w
11575 & 11577 SW LOMITA AVENUE
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Address 1,4VN1,F•4 X11-Permit No. �5�0
Name of Occupant /CC AEQr� v�f�f� Permit charge
Connection fee O o. 00
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Date connected �-
Type of Building_ _�v LInspection fee
Service Rate_'T fj i Paid by Date
Contractor 0C ✓� al -.- Astiest.ment— -Paid_
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Size of connection
PERMIT TO CONNECT �o qM
Tigard Sanitary District
PERMIT N° 740 DATE� &3
PERMIT I5 GIVEN TO /�
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT IIS737-� 77
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEF. P:.:D $.�.�...�......... TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED IND APPROVED
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Date ndent