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13265 SW ASH AVENUE
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Address Permit�! Sly— sf/ _ Permit No.
Name of Occupant TCat f/ /joeAAF/e Permit charge._-__' _
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Connection fee
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Date connected /.2
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Type of Building _ ._ Inspection .;e�, _
Serv;-e Rate_ `�" - Paid by .�l��i/��c,� Date �i��Sl
COLtractor /I �/s G/C�
_._ Assessment Jaid _
Siad of connection__�_
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PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT N? 7r 7 DATZ
PERMIT IS GIVEN TO
OF
i
TO CONNECT A_Y
TO THE STSTEM OF TIGARD SANITART DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRI PRE
MISES UNTIL CON-
PLETED•
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PERMIT FEE PATI)
.................... T
r
CONNECTION INSPECTED AND APPROVED
SuPerlr►tsadent __-_.. ._...__.._
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