13755 SW 114TH AVENUE-1 13755 SW 114TH AVENUE
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PERMU TO CONNECT
Tigard Sanitary District
PERMIT No. 15'96 DATE
PERMIT IS GIVEN TO
OF �-
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT ,
THIS PERMIT 5111ST BE POSTED ON TF E DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF C✓ivNECTION IIAS BEEN COM-
PLETED.
PERMIT FEE PAID $...................................T/GARII SANITARY DISTRICT
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CONNECTIONIINSPFL'TED AND APPROVED
S
Date Superintendent ✓
Address 13755 s.� . 114th Permit No. 15_x6
Permit charge
Owner Columbia t;usttom Homes Connection fee 400.00
Paid by�
Type of building Rt:sideaqu Date connected
Service rate -1-00 r»r mntith Inspection fee �5.tao
Contractor l'.nItimt•is; Cuntnm Nntnnn paid by_ m nate
Size of connection 411 Assessment Pa.Ld
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