11945 SW BURLCREST DRIVE-1 1
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11945 SW BURLCREST DRIVE
Address Permit No. t,7
Name of Occupant_ Permit chazge ,__._.-,-,
Connection fee
Paid
Date connected
Type of Building Inspection fee
Service Rate Paid by _ _ Date
Contractor Aswtqsment—.–., Paid
-
!;iiv )I connection
PERMIT TO CONNECT
City of Tigard
Permit XT l
DATE
PERMIT IS GIVEN
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TO CONNECT A-_�L__�__...__''' L�)
TO THE SYSTEM OF CITY OF TIGARD
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THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON"
NECTION IS MADE AND INSPECTION CF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID ; CITY OF TIGARD
CONNECTION INSPECTED AND APPROVED
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Def,- Superintendent