13700 SW 115TH AVENUE r �
r
u
PERMIT TO CONNECT �,,S
Tigard Sanitary District
PERMIT N9 1595 DATE
PERMIT IS GIVEN TO ___ ---s-- - -----
OF
TO CONNECT A -_______ ---------_ _-_----- ----
TO THE SYSTEM OF TIGARD SANITARY DISTP.ICT
ATTHIS PERMIT MUST BE POSTED ON THE DE'+CRIBED PR1?.MISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID 1.... .t.......................TIGARD SANITARY DISTRICT
w
CONNECTION INSPECTED AND APPROVED
Date
superintendent
Address 13700 S•w• 1-15th Permit NO. 1595
Permit charge
Owner victor Lundin Connection fee 4o0•oo
Paid by Columbia Custom
Type of bui.lding Rp rjdr,,nec Date connected
Service rate 3_nn ;er mmntti Inspection fee 25,0 j
Contractor r.,�„mbt� c��tom _ Paid by Columbia Custgyhte_ 3-15-72 Q
�! Size of connection
Assessment ?aid
`•fit.cj j 1
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4
1
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