12085 SW 116TH AVENUE-1 12085 SW 116TH AVENUE
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PERMIT TO CONNECT
Tigard Sanitary District
P,URMIT N9 1075 DATE _
PytMIT IS GIVEN TO
OF
TJ CONNECT A -------
'TO THE SYSTEM W TIGARD SANITARY DISTRICT
AT
THIS^PERMIT MUST BE POLTED ON THE DESCRIBED PREMISES UNA'TL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BIEFEN CO1VI-
PLETED.
PERMIT FEE PAID $...4 .. ................... ...TIGARD S INITARY DISTRICT
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CONNECTION INSPECTED AND APPROVFUD
Superiniendent
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Address 116 Z-A, Permit No. /��
Permit charge 1
Owner _ Connection fee
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Type of Building _W Date connec;:ed_� i
Service Rate Inspection fee_
Contractor Paid by DateZ -/3-e,k'
Size of connection Assessment Paid