11485 SW 90TH AVENUE _ 1.1485 SW 90TH AVENUE
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PERMil' TO CONNECT
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Tigard Sanitary District
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PERMIT No 1047 ►ATE
PERRIIT is GIVEN TO
OF
TO CONNECT ---
TO THE SYSTEM OF TIGIARD SANITARY DISTRICT
AT
THIS P:PRIWIT MUST BE POSTED ON THE VESCRIDED PREMISES UNTIT CON-
NECTION IS MADE AND INSP 1CTION OF CONNECTION HAS BEEN COM-
PLETF.D.
'eERMIT FEE PAID 11.. . .._. ... - - ..........TIGARD SANITARY DISTRICT
----- -------
"wwrna V�I�/rAlwEl�'!uA✓l..wr.n f,ar4M.A.�YrMIr
CONNECTION INSPECTED AND APPROVED
Superintendew
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ll fir. s e).ha►ng*.d en map to.
F7 45- ;w qC,,1*
AddressllqrS:,hy Permit No.l_6 7
Name of Occupant Permit charge 16 __
tuwJ �G16 Cotmection fee ,
Paid bq SII+
Date connected 1Z / •G Z
Type of Building �✓ ) Inspection fee
Service Rate -�° Paid by _ —Date
Contractor. Assessment Paid
Size of connection
� s� S 5 08 TL - 400