11475 SW 94TH AVENUE 11475 SW 94TH AVENUE
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PERMIT TO CONNEC 1'
Tigiud Sand-ary District
PERMIT NI) 1 it P 3 DATE - -�......-_±----
PERMIT IS GIVEN TO
OF ---
TO CONNECT A_TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT -__! ---
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION ]1rAS BEEN COM-
PLETED.
PERMIT FEE PAID ...........................TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVIsD
-- - - _
Date Superintendent
Jowl
//j47 _
41 - 1
Address - -- Permit No. /0o j— -- -
Name of Occupant�_�t/��- Permit charge_•��_ __ -
Connection fee?SAO
Paid byk4 �A.'� —
Date connected-I& 2 '3'�►7
Type of Buildinq 't S _ Inspection fee /O _.�---
Service Pate __-_ - Paid by Date__
Contractor. Assessment
Size of connection -