10030 SW JOHNSON STREET 10030 SW JOHNSON STREET
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PERMIT TO CONNECT
-Sanitary District
Tigard
PEWIT N? 663 --
PERMIT IS GIVEN TO.._` ,_? ...�. ' � 1�,• t�. } 1_..i;�.�re
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TO CONNECT ATO TILE SYSTEM OF TIGARD SANIVARY DISTRICT
THIS PERMIT MUST BE PO'ATED ON THE DESCRIBED PREMISES UNTIL.CON-
NECTION IS MADE AND IN°PECTION OF CONNECTION HAS BEEN COM-
PLETED. M
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P!:RMIT FEE PAID ...........................TIGARD SANITARY DISTRICT
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BY
MNNECTION INSPECTED AND APPROVED
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Tax Lot 2 SI 2 Br 120( 23-10 North Tigar.dville Addn.
Assessment 605.64
Lateral 68.14
678.74
11-1-61 33 .69
& SA thereat ter
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Address O/. '�r
L__. 3Q ��!�_Z� Yld = Permit No. (�/
Name of Occupani.--,�,, Permit charge_� 0(0 ---1—_
Connertion fee '4 o(�1t'
-------- --._ -- _ ----- -- Paid by
Date connected
Type of Building Inspection fee_
Service gate
Paid b Uate
- - -- -------- y -------- dd-- —
Contractor_ Assessment�. __PaidY-_�__-�
Size of connection