10410 SW JOHNSON STREET-1 10z}lo SW JOHNSON STREET
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PERMIT TJ CONNECT
Tigard Sanitary District
PERMIT j%To 749 DAT18 � ��" -
A A
PERMIT IS GIVEN TO
OF
TO CONNECT A fv/ f �►t
TO THE SYSTEM OF TIGARD SANITART DISTRICT
AT ly / (!_— , Z/ /,!X t ae"t/
THIS PERMIT MUST BE I OSTED ON THE DE9CRIBE►l FREMISES UNTIi,;eY-
NECTION IS MADE AND INSPECTION OF CONNECTION 1;AIS BEEN COM-
PLETED.
PERMIT FEE PAID $.::.`.............................
C014NECTION INSPECTED AND APIMC.aD
Rate ^--" Superltitendent -------
r.
Address _���//o S GG'. ..�o�/�y So,��.f1�Permit No. 'f
Name of OccupantWIGlk%r Permit charge __ r �• m
e^
---. Connection fee ��? .S`Q
- ----- Paid by_ 7,_ I-ell l o
- ------- ___ Date connected /9,�C-�
Typo of Building— C SiUC 1.1C( _ Ir.dpection
service Rate--- ✓ Paic: by _cr ��c' _Date
Contractor MFS �����/�(,,r /r Assessment._—V Paid
Size of connection