12490 SW KNOLL DRIVE 90
12490 SW KNOLL DRIVE
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Address �- /��,eoPermft No.
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Name of Occupant Permit charge
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__ Connection fee_ r -� •5L
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Date connected
Type of Building Inspection fee_ `' c~
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Contractor Assessment Paid
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PERMIT T`O CONNECT
City of Tigard
Permit No 526
PERMIT IS GIVEN TO_ ,
TO CONNECT A
TO I-E SYSTEM OF CITY OF TIGARD
,HIS PFRMIT MUST BE POSTED ON THE U'ESCRIBNO PREMISES UNTIL COW
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID A ✓_-_----- - - CITY OF TIGARD
CONNECTION INSPECTED AND APPROVED
Date Superintendent