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12575 SW BROOKSIDE AVENUE-1 f 1 •r OW Mow Lq Y CL 4 1 -'515 SW R 1' "9 h tA: 1 BROOKSIDE AVENUE **4y .h D, Address 9 6 S^�S �'W �,e+�4.sQpv�. Permit Ido. Name of Occupant-_ —. Permit charge -�2 - Connection fee ---—-- --- - _ Paid by--- -— - -- ---- — - - - - -------- Date connected Z (e Type of Building - -_- -_ ------ Inspection fee Service Rate Paid by _ Date 11 Contractor ,Assessment Paid Size of connectiont of Tigard Permit N? 690 PATE � .�Srwf►—__-- PERMIT IS GIVEN TO - JOE OF 1.1d X %-s -- TO '-ONNECT A.-_.-3--,, -1 ��L_-------..--- '"O THE SYSTEM OF CITY OF TIGARD AT .. y A 1 - - —THIS PF--RMIT MUST BE POSTED ON THE DESCRIBED PREMISS UNTIL CON. NECTION IS MADE AND INSPECTION OF CONNFCTiON HA; BEEN COMPLETED. !cl PERMIT FEE PAID �. - _ _ _CITY OF TIGAF D By �--- i CONNECTION INSPECTED AND APPROVED Date —�YplPlnfenden —__