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13295 SW ASH DRIVE
Address,. /��?1��3�..5"ly. sfa'-�!'�rF Permit No.,
Name of Occupant �� ti r' �1�'�E � Permit charge
Connection fe-
Paid by 2WAslEl
— ----- - - --— Pate connected
Type of Building
E_.`s/DFic Cc
P 4 Inspection fee
Service Rate #,�`0OPaid by �' ! o%%C. Date
Contractor A/•y,cs
Assessment Paid
Size of connection //
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N 776 DATE.,�CC. 4 �'�(►�►� _
PERMIT IS GIVEN TO ���/ ._s _✓ , _
OF �'�} L41 �', • ---
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
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THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM
PLETED.
10 70
PERMIT FEE PAID .................
By . r
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CONNECTION INSPECTED AN-,I .WPPUQVLD
Date ---- - ------- Superintendent�_�--