14865 SW 72ND AVENUE-2 --- 1.1865 SW 72ND AVENUE ---
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Address14 s- I,, /t J Permit No.
Permit charge
Owner j Ll1,L.j ,,, } i x I (k c Connection fee
Paid by _
Type of F,uildin
yp g_,._E- .,��c Date connected
Service Rate` y// 7- 7r.> R Inspection fee �_ i-•
Contractor Paid by Date
Size of connection` y�' Assessment Paid
CAL-
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT N9 1161 DATE
PERMIT IS GIVEN TO /1
- �..d-'7»�`y+CS_
TO CONNECT A F'
TO THE SYSTEM OF TIGARD SANITARY DISTRICT � �-
1 .1 8 G,V
AT •'y'
THIS PERMIT MUST BE POSTED ON TNR:DESCRIBED PREMISES UNTIL CON-
NECT ION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM.
PLETIRD.
PERMIT FEE PAID $......-'.... ......TIGARD SANITART DISTRICT
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By �!
.MAA�A
CONNE-.TION INSPECTED AND IiP!'KOVrD