13505 SW VILLAGE GLENN DRIVE 13505 SW VILLAGE GLENN DRIVE
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 1112 DATR
J
PERMIT IS GIVEN TOOF
TO CONNECT A ---
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT i1IUST BE POSTED ON THE f1E•9CRIAFD PREMISES UNTIL CON-
NE(TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $ _ .............................TIGARD SANITARY DISTRICT
By
('ONNE("TION INSPECTED AND APPLOVED
- -
dent
Date -- _--- Superintcn
Address Permit No. � —�
Permit charge
Owner _ -
Connection fee .4
Paid try-�� [�ayo
Y_ype of Luilding _ Date connected
Service Rate __ _ Inspection fee /G' -_
Paid by ,/ , -Date U v!
Contractor ��,�, as � `-
Size of connection Assessment__ Paid
1