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10495 SW CANTERBURY LANE
Address—�Ts/�s �5,�%,. C�� Permit No. /3�9
Permit charge__,,p«
Owner j , .� �en� Connection fee ,; &
Paid by �.._
Type of building Date connected
Service rate. Inspection fee__ Z,
Uontractor Paid. by —Date--.--.
Size of connection / '�_ _ Assessment— _ Paid--_
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PERMIT TO CONNECT
�1 Tigard Sanitary District
PERMIT N? 1319 DATE
PERMIT IS GIVEN TO — - - �----�_,--__-y --_ —
OF
TO CONNECT A --___---
TO THE SYSTEM OF TIGAVD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PRFMISE.9 UNTIL CON-
NF.'CTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEF PAID $....................................TIGARD SANITARY DDSTRICT
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CONNECTION INspvcm AND APPROVED