11955 SW NORTH DAKOTA STREET 11955 SW NORTH DAKOTA STREET
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PERMIT TO CONNECT
Tigard Sanitary District
PERMITN.a r
J S J DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DE,SCRIDED PREMISES UNTIL,CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEF. PAID �._. ...................TIGARD SANITARY DISTRICT
By ----
CONNEC,,'rION INSPECTED AND APPROVED
--- --- Date �V_ Superintendent
Address A/f.5s, A/A0& !V—rA-jX Permit No. 9gts7
Name of Occupant___ Permit charge I- --
Connection fee.—&.$-V-
Paid
------ Dete connected
Type of B uildinqjo Inspection fee.. /0-------
Service Rate Paid by ___ __ Date
Contractor. Assessment-- Paid
--
Size of connection