11435 SW 90TH AVENUE-1 VIM
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PERMIT TO CON'NEr''r
Tigard Sanitary District
PERMIT N« 763 DATE
PERMIT IS GIVEN TO017
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TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE D CRIBFD PREMISES 174TIL CON-
NECTION IS MA«E AND INSPECTION OP' CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID �.�L'"...� .................
CONNECTION INSPECI'ED AND APPROVED
Date Superintendent ~�--
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Address Permit No. ,� 3
Name of Occupant Permit charge_ 2
Connection fee 41.�p�7' \�
Paid by /X
Date connected41
Type of Buildinq ,5�,�c!C Inspection fee fe,
Service Rate "� Paid by Date b �y
Contractor 1"S Ae r7 Assessment Paid
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Size of connectior