11660 SW BURLCREST DRIVE-1 r
!
r.
s��e
C�
a '
r
r DRIVE11660 SW BURLCREST
' r�
J
Address//$16*fw Q r.*&ax Permit
Name of Occ ipant__ Permit charge_ 1
Connection fee .2 So —
— �..._ ---- --— --- Paid b, _--- —- —
Date connected 2 7
Type of Building_ _ /aIj _ inspection fee--,10 — -
Service Rate _ Paid by Date
Contractor_ - Assessmeni Paid
Sire of connection _
r
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT Nv 9►78 DATE - -- ------
PERMIT IS GIVEN TO
OF
TO CONNECT
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON
NECPION IS MADE AND INSPECTION OF CONNECTION HAS $REN COM-
PLRTVD.
PERMIT FEE PAID $ ..... .......................rlGARD SANITARY DIST.—aCT
By
------- -- -- ---- - - - - - -
CONNECTICN INSPECTED AND APPROVED
,/o,
---�-- Date --�— Baperiutendent