13410 SW VILLAGE GLENN COURT 13410 SW VILLAGE GLENN COURT
1G
PERMTT TO CONNECT.
Tigard Sani--ary District
PERMIT N° 1076 DATE
PERMIT IS GIVEN TO ;
OF
TO CONNECT A�To THE tITSTEM OF TIGARD SANITARY DISTRICT
AT 41
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES uNTH,CON-
NEC7ION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE .PAID $. . . ..........................TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVc'V
-_- �._._.__.. , 13nperintendent
Date Am
i
J r-
Permit No.� Z�-
Permit charge �sp
Owner-- Connection fee ��c ✓�
_ Paidby
Type of Building _ Date connected �1y�G4
Service Rate Inspection fee /0-�
r Paid � , d ,� ate 21
n�/��
Contractor ��-r��, f� c�c +q�,__ Y„�C1L ;__ ��'/�-�'
a
Size of connection AssessmentPaid`
F