11765 SW TIGARD STREET 11765 SW TIGARD -qiM(r OIL
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PERMIT J CONNECT
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Tigard Sanitary District
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PERMIT IS GIVEN TO
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TO CONNECT A - --- ----- --- ---
TO THE SYSTFA OF TIGARD SANITkRY DISTWCT
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THIS PERMIT MUST bE PORTO ON THE DESCRIBED PREMISES UNVL CON-
NECTION 11 mADE AND INSPF`.CTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID sr...,2., ' . . TIGARD S.INITAR r)ISTRIC'a'
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CONNECTION INSPECTED AND APPROVE)
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(f Permit charge
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Owner—,,- „_ .,� �,'; � a Connec-ion fee� ,�a
Paid by
Type ct Building`'// ,— Date connected
Service Rate Inspection fee_��
Cnntractor Paid by Date
Size of connection Assessment Paid
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