10495 SW JOHNSON COURT 10495 SW JOHNSON COURT
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INSPECTION NOTICE
City of Tigard Building Department
( P O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection -----_r�.:1i�1'4-IV`-- _..
Date Requested -7—_�— Time ___._— A.M. P.M.
Address (�.c �y'1 �.5.-�e.Ls./�.1_� _ �•�� --- Permit * —
T Lot
Owner - --- —
Builder ---__� _-�-- -- --The following Building Code deficiencies are required to be corrected:
JulPresented to — _ ❑ Apprnved
Inspector /YJ ❑ Di+approved
Date
CALL FOR REINSPE WON
C7 YES 1 1 NO
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 773 DATE/ G V. ••r, P76
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PERMIT 18 GIVEN TO
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,CO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
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THIS PERMIT MOST POSTED ON THE DESCRIBED PREMIE S UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED. ,
PERMIT EEE PAID
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By
--- - - - -- --- - --
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CONNECTION INSPECTED AND APPROVED
----__ Date - ��^ Superintendent---- - ---
Address- 2 0 4.l k) �% Permit No.___ -
Name of Occu ant JAc�c
p f1,�%>>Cti Permit charge
Con.lection feel r2.5T'
------ --- Paid by-_---y. A/11//p c"t.
Date
_ connecte-el—
TYPe of Building D�tir e E- Inspection fee � %���
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Service Rate i �n 0 Paid by _ ��'/�p e�Date_
Contractor
Assessment Paid
Size of connection