12580 SW KAREN STREET 12580 SW KAREN STREET
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PERMIT TO CONNECT 'e w
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Tigard Sanitary Distxict
PERMIT N° 1582
PERMIT IS GIVEN TO �
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
27
THIS PERMIT MUST BE POSTED ON THE DERCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $......."'`'����...... ..............{ f�
` ..TIGARU SANITARY DISTRICT
... DISTRICT
r'�s.u• t.r. +� By
+ ' L46 _4
CONNECTION INSPECTED AND APPROVED
Date _._.._.Superintendent _ _
J
I
Addre:,42580 S.W. Karen Perrvit No. 150 ..._
Permit
Owner Uwe S. Bmrdway Connection fee401:.00 _
Paid by__.D'° Coxw6ruction�
Type of building Residence _W Date connected _ Mo Data
Service rate 3.0G per mouth_-_... Inspection fee_._ 25•�
Contractor Dale 0oustruction _ Paid by Dgll.Con�t. Datf
Size of connecticr� _ Assessment-- .