11950 SW KATHERINE STREET-1 11950 SW KATHERINE STREET
I
m
q
t.
v
.t9
u
3
v:
C
a
I
Address /
Permit No.jo')�.
Name of Occupant_ Permit chaige_�---- _ - - -
---------��__ -- Connection fee
----- -- - - --- Paid
-- Date connected
T pe of I3uildinc Inspection fee
Service fiats Paid by - - Date
Contractor -- _ -- A,ssessment___- __ - PP id
Size of connection
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT r►► , 922 BATE _.
TO
PERM!'.` IS GIVEN 7 J 1 1-••
t
OF
TO CONNECT A
r0 THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISEF,UNTIL CON-
NECTION IS MADE APID INSPECTION OF CON*. SCTION HAS BEEN COM-
PLETED
PERMIT FEE PAID $.... ................. ......TIGARD SANITARY DISTRICT
BY
�vwr.ww.
CONNECTION INSPECTED AND APP11OVED
-------_ Date { 'Superintender4
t•-