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11715 SW BURLCREST DRIVE
Addr®se ��7/S ,Q�cit fS7��_ Permit No, li— --- -- ----
:1amo of Oocnpant_ __ Permit charge .
Connection fee
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— -- Date connected-,5-7- f l
Tvpe of Building_-_ _._ Inspection fee
Service Ante --- -�_- - Paid by -
- Date------- ----
Contractor Assessmtnt Paid
Size of connection
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PERMIT TO CONNECT
Tigard Sanitary District 1l
PERMIT N9 926 DATE
PER3IIT IS GIVEN TO k -�
OF
TO CONNECT A !
TO'INE 87STEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MIDST BE POISTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS P'a;N COM-
PLETED.
PERMIT FEE PAID
-
.. .............T1Gt&RD SANITARY DISTRICT
CONNECTION INSPECTED AND APPI0"S
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—.Date 9+ipea#iiteent —--