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PERMIT TO CONNECT
Tigard Sanitary Dlsk.ri.ct
PERMIT N? 9 Cl,Y DATE
I'V10117' IS GIVEN 1'0
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 9.4 MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID #.....-............................TIGARD SANITARY DISTRICT
By - .I -
- 13
CONNECTION INSPECTED AND APPROVFD
Date Supet'lnte.- ent
f
Address._ --'� G(i /ysf, 14"r Permit No.
P �� �1�91�l7 r5,t�
Name of Occupant ��� � Permit charge
- — --- - Connection fee
-- Paid by-- e4//��a�_.,`
- -- --- Date connected
Type of Building_:+ Inspection fee �� cc
Service Rate—.j Paid by-rglUi 114r Date
Contractor i, - //n c Assessment_ Paid
Size of connection % '
PERMIT TO CONNECT
Tikjard Sanitary District
PERMIT 101c> 7 S 8 DATE > J _
PERMIT IS GIVEN TO
OF
TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT ILL!
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETEO.
PERMIT FEE PAID $.... .........................•..TWADD SANITAftrlff*RICT
By
CONNECT143N INSPECTED AND APPROVED
Date Superintendent