11525 SW TIGARD STREET 11525 SW TIGARD SMOST
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PERMIT TO C:JNNECT
Tigard Sanitary District
PERMIT N? 1398 DAT4
PF.R311T IS GIVEN TO
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TO CONNECT A
TO THE SYSTEM OF TIGARD SANtIART DISTRICT
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THIS PERMIT MUST BF POSTED ON THE DERCR.IBF.II PREMISF'S UNTIL CON-
NECTION IS MADE AND IWPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAID ... .....TIGARD SANITARY DIS WRICT
BY
CONNECTION INSPECTED _etkl) APPROVED
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Date
SuperintPnder)
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Addiess 4 Permit No,
.� Permit charge
Owner --
v �/,cr Connectj on fee r- 7 r
Paid by
Type of building �Cew, Date connected_�y '
Sery+.ce rate
_ Inspection fee_ ,--c
Contractor
Paid by` --_Date
Size of connecti.ol, ell
! Assessmenc _ Paid
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