11730 SW 116TH AVENUE-2 iii 1_1Ji Ll ULlLl Llii iii
1.1730 SW 116TH AVENUE
d*
I
1 '
�r o ■r � �' o � ar �r �
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT NY 11 O�. DATE
PERMIT IS GIVEN TOw
OF
4
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE I)FSCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPIICTION OF COINNECTION HAS BEEN COM-
PLETED. J'
PERMIT FEE PAID �... 5,. {� Q�moo...TIGA"SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date SuperLtitendent
■
Ac:dress / ! 730 �.G✓ / �y ��_ Pex.mit
Permit chargees —
Owner L�.d� d��_i Connection fee 2 ay
Paid by_.�. _—_
Type of Building— __—_ _ --- Date connected
Service Rate a Inspection teems
Contractor _ Paid by_al-�- Date
Size of connection-4 _ Assessment—___ Paid