14475 SW CANTERBURY LANE 0
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14475 SW CANTERBURY LANE
PERMIT TO CONNECT
Tigard Sanitary District
No
PERMIT N? r921) DATE
PI?RMIT TS GIVEN TO �, _ •:� _
or
TO CONNECT A
TO THE SYSTEM OF TIGAR•D SANITART DISTRICT
AT
THIS PERMIT MUST BE FOSTED ON THE DEgCITIBVD PREMISES UNTIL CON-
NECTION 18 MADE AND "NSPECTION OF CONNFCTION IIAS BEEN COM-
PLETED.
PERMIT FEE PAID E._ ............................TIGARD 9ANRTART DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date Superintendent
' 4
Addreee �_ lIC��NIt_ Permit N �_ r
Name of Occupant Permit charge-,--2--
Connection
harge-_.-2Connection fee Z300
-_. --- ..._ ----—------- Paid by---- —-- ---------
- - - --- -- - - - - Date connected.
Type of Building_--.._-- ---.-.-- -_ Inspection fee- ----------.__-.__—
Service Rate_ --- -- _.__..-- -- Paid by - Date_,—_—�
Contractor�. -- -- - -- Assessmcwt_- - - _Paid__.._ ---
Size of connection