11780 SW BURLCREST DRIVE r -
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1178J SW BLJRLCREST DRIVE
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Address.,//- vog.c e_el_7 _ �- Permit No. �;-'2 07
Name of Ocrmpant. _ _ Permit charge
_ Connection fee_,_`
Paid by–_—__--
Date connected
Type of Building. _--- ------ --- _ - _ _– Inspection fee__-_ -
Service RatePaid by . _-- _Date
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Contractor_ Assessment Paid
Size of --onnection
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT No 902'7 DATr '/ l
PrRMir IS GIVE14 To
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TO CONNECT A
TO THE SYSTEM OF TIGAP_D SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON TILE LIE4CRIBED PREMIS'„8 UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
I'LETT 1.
1-..^.RMIT FEE PAID ;.... : ..................TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AX'?) APPROVED
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Date Bnptrintendent
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