12730 SW PACIFIC HIGHWAY 12730 SW PACIFIC HIGKWAI'
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Address7 30 5 W Permit No. -
Permit
o. -Permit charge
Owner Connection
Paid by dkc,�
Type of Building Date connected 6� Ly
Service Rate Inspection fee10-e9
Contractor Qct".. Y�L _ Paid by Q d" -SJ IA�Date 3-6 -64'
Size of connection 6Assessment Paid
PERMIT Tr) CONNECT
Tigard Sanitary District
PERMIT V t08'0? I, 1 T E
PERMIT IS GIVEN TO
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OF' _ I.
TO CONNECT A
TO THE SYSTEM OF TIG%RD SANITAP:Y DISTRICT
AT
THIR PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL.CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $.. ............................TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date Supetintendent