11825 SW ANN STREET N
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11825 SW AN'i STREET
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Add ressz \5 Permit No.
Permit charge_
Owner _, '� .s�c1 7L �C, Connection fee
Paid by—
Type of building Date connected I—P11-1-7e)
Service rate Inspection fee
Contractor' Paid by Date
Size of connection Assessment Paid
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 13220 DATE
PERMIT I-i GIVEN TO
OF .........
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE Pl 10 $ .... ..... .. ................TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
--jj�u�rtnteM—nt
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