11280 SW 90TH AVENUE r ♦ y
11280 SW 90TH AVENUE -
r'J
PERMIT TO CONNECT
Tigard Sanitary Distric
PEWIT N? 770 DATE _/�'_ ��, '✓'
PERMIT IS c:Id'EN TO r'
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DERCHIRED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION ][AS BEEN COM-
PLETED.
PERMIT FEE PAID ....:"`...........................TIGARD SANITARY-ffL"lH .
By
.nw.n.. `r
%F
CONNECTION INSPECTIA) AW) jai"t'uO1'1�1
Lute Superlpteudet t
VMF
Address-1-1— �l 1 D ,SlV` O� Permit No._
a
Name of Occupant < < Parmit charge .—
Connection fee ---
Paid by__
Date. connected
Type of Building �C3/p Z-'a Inspection fee
le, r �'f if�l�r _Dat.
Service Rate— �• e,o _ Paid by _
Contractor C- ���oc/�" ���� Assessment Paid
Size of connection '�