10065 SW JOHNSON STREET 10065 �M JOHNSON STREET
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.PERMIT TO CONNECT
Tigard Sanitary District
PERMIT No 798 DATE -
' PERMIT IS GIVEN TO � �~C � �v ( t l
OF
TO CONNECT A
TO 7;IE SYSTEM OF TIGARD SANITARY WSTRICT
THIS PERMIT MUST RE POSTED ON T'dE DESCRIBED TAREltiISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PEktMIT FEE PAID $.... ..................... .....TI0*RDI§AlglTAltY-blO1tyCT
ar
CONNECTION INSPECTED AND APPROVED
� A of
Su erinten.le^ ,
Tax Lot 2 SI 2 BB 900 23-10 Worth Tigardville Addn
Assessment 525.19 /W 1
Lateral 69.4
594.59
$500 pd 5-22 -61
Address 4i.Q4 � :� 22. 'permft No._
r
Name of Occupant_ di Perrr it charge
-------- - - Connection fee
Paid by
- -- - - Date connected 5
Type of Building
Insp,.+ction fee_z.
._ _`---
Service Rate_-- .J G)
____--. — Paid by --Date_
Contractor---.----- - -- _-_-- Assessment, ` . Paid
Size of connection