13400 SW VILLAGE GLENN COURT 13400 SW VILLAGE GLENN COURT
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PERMIT TO CONNECT �55,-�2
Tigard Sanitary District
'ERMIT 1430 DAT�e
11 T
PER311T IS GIVEN TO
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TO CONNECT A
TO THE SYS.FM OF TIGA7RD SANITARY DISTRIC`C �
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THIS PERMIT MUST BE POSTED 01 THE'I�F.9rit[BFD PRFMIfSES UNTII.CO' - c
VECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN C01I-
PIXTED.
FFRMIT FEE PAID $..................................TIGARD SANITARY DISTRICT rera 1
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CONNECTION INSPECTED AND APPROVED
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Date Superintendent
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Add-Ase Permit No.- 30
Perch t charge
Owner `�. /C `Jr l��' -- -� Connection fee_ �1S �'
Pa'_d by _-
Type of building__ Date connected_
Service rate ` '-5g Inspection fee
Contractor laid by Date
�� Assessment Paid
Size of connection _� ------