11665 SW KATHERINE STREET-1 11665 SW KATHERINE STREET
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Addressl� Permit
Name of Occupant Permit charga
Connection lee
Paid
Date connected—L--j I-A 7
Type of Buildin j Inspection fee.
Servicc, Rate Paid by Date
Contractor Assessment Paid
Size of connection
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PERMIT TO CONNECT
City of Tigard 7
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Permit
PERMIT IS GIV17N
OF
TO CONNECT A---.-
TOTHE SYSTEM OF CIT-1 OF 716ARD i
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THIS PERMIT FAUev, rsR POSTED ON THE DESCRIBED PREMISES UNTIL COW
NECTION IS MADE AND IIISPECTI'IN OF' CONNECTION HAS SEEN COMPLETED.
— CITY OF TIGARD
PlRMIT FEE rAID 5-- —
i By —
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C.ONNECTIO0 INSPECTED AND API-F,OVED
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