10265-10275 SW WALNUT STREET 1b ■
10265-75 5W WALNUT AVENUE .�
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PERM I TO CONNECT �¢�G
Tigard. Sanitary District 1
PERMIT N° 973 DATE
PERMIT IS GIVEN TO
OF _a TO CONNECT A -�
TO THE SYSTEM OF TIGARD SANYrART DISTRICT
AT
THIS PERMIT�MUS'P BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
kiRNIT FSE PAID $.......�...af.................rIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date _ —_Superintendent
v
Yddress - -- G Permit No._ T-- -- -----
Name of Occupant _ _ �_� Permit charge _
Connection fee_
Paid —
Date connected wl
Type of Builrlin.g __-___.._. Inspection. fee--
Service
ee__Service Rate -- Paid by - _ Data
Contractor _._ �_—_-- Assessment_... __-- - _ _Paid----__-. --
Size of (;onnection
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