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PERMIT.' TO CONNECT
Tigard Sanitary District
PERMIT Nu 703 DATE
1 PERMIT IS GIVEN TO N,
OF
TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT /
THIS PERMIT MITST BE POSTHb ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ......f.............................TIGARD SANITARY DISTRICT
By , ��
CONNECTION INSPECTED AND APPROVED
Date TSu ndent
Address��d ����` `?^'�/� Permit No.
�i
Permit charge
Name of Occupant _ ?_1- _
Connection�fee—..4Q
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Paid by �°''1 .1.' -
_ Date connected
Type of Building s- _ _, Inspection
GJ
Service Rate Paid byc��*" _1! Date__ 9� y
Contracto x� _` Assessment Xa--I,,a Paid
Size of connection---f- r/ C" ` � _