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13450 SW CRE•SMER DRIVE
Acirlress
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Permit char(-re_
z, Connection
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Paid by
Type of building Date conn(�cted A
L;ervico rate Inspection fee -;2,
Contractor. Paid by
13 P
Ili,,e of connection A S. Z M t,11 t --Pal d
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PER141T TO CONNECT
Tigard. Sanl'L-ary Dis-l-rict
PERMIT N ' 1419 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
JIFRMIT FEE PAID $ . ....... .... . ..........TIGARD SANITARY DISTRICT
- - - - - --- - - -------
CONNECTION INSPEcTFI) AND APPROVIA)
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Date -jitip-ijin dWf