12748 SW PACIFIC HIGHWAY 12748 SW PACIFIC HIGHWAY
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Address-19-7 Of t Permit No. A2
Permit charge
Owner. Connection fee A'�� ,...
Paid by
Type of Building - Date connectedOME
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Service Rate' r,_ . Inspection fee
Contractor-------- ____ Paid by —__—!Date —
Size of connection Assessment Paid
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PERMIT TO CONNECT,-,
T.;.gard Sanitary Distrirt
PERMIT No 12`'Q DATE
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PERMIT IS GIVEN TO.
OF
TO CONNECT A_ //10 �F Taj_,
TO THE SYSTEM OF TIGASRDASANITART DISTRICrT
THIS PERMIT MUST HF. POSTED ON THE DESCRI FD PREIWISF.S UNTIL CON-
NECTION IS MADE AND INSPECTION OF CGNNF,�TION HAS BEEN COM-
PLETF^,
PERMI'1 FEE PAID $-...41,11-4.1.................TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
_ _ Date ------ ---_ --�—�
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