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13225 SW ASH DRIVE
Address,O�2.Zs r/�_!�� �4 PermitNo.
Name of Occupant________ __ Pernrc charge ____
Con•.ection fee
Paid by ------ -- --—--------
Date connected-_1s7_�Q=
Type of Building_ __ Inspection :ee
Service Rate---__— --_-__- Paid by Cate_.__��-_�
Contractor_ AFsessment_ Paid I
Size of connection
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Address_ , -i� l-� `S L�✓" 171"xl '9T. Permit No._____ fC,l
Name of Occupant ,(l,- x Permit charge C..9 ca
A
-- Connection fee 4r2,—,3-C• ze"
------- -- Paid by T GU, //o c/tom
Date connected
Type of Building i j c'.•54pe NC'[ _ Inspection fee__ OC
Service Rate �r?.c ' y _T ! Date �/
Pai<< b l //C: /( (I
Contractor Asses-.nent Paid
Size of connection 404.,
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PERMIT TO CONNECT
City Ti ,ard
Permit
PERMIT IS GIVEN
TO CONNECT A
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE . AID ��
------�--____ OR TIGARD
CONNECTION INSPECTED AND APPROVED
Date