13220 SW VILLAGE GLENN DRIVE 1322U SW VILLAGE GLENN
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PERMIT TO CONNECT
Tiq<.�.rd Sanitary District
PERMIT N9 I 9 DATE
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PERMIT IS GIVEN TO
OF _ --
TO CONNECT S
TO THE SYSTEM OR TIUARD SANITARY DISTIIICT
AT— -— .. - __ ------ -------- _---JTHIS PERIVIT MUST BE POSTED ON THE DESCRIBED PREMISES, UNTiL CON-
NECTION 1,3 MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
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PERMIT FEE PAI11 a ... .........................TI .ARD S,0 "AR3t DISTRICT
By
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t"INNECTION INSPECTED AND APPROVED
- -- --Date - -- ---- Superinter(fent
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Address 0l�pRPermit No.1�Q
Name of Occupant Permit cha% ? --
__ Connection feo 2 J'o —
Peed by
Late connected_ '_ A Z_
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Type of Building_ �_ A.� Inspection fee /6_4 t,
Service;date Paid by Date
Contractor AssessmentPaid
Size of connection