11965 SW 118TH AVENUE L l u iJ ii
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PERMIT TO CONNECT Ilk
Tigard. Sanitary District
PERMIT N9 965 DATE ;
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I'F.RA1T7' IS GIVEN TO ..�] .
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OF
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TO CONNECT A
TO THE STSTEM OF TIGARD SANITARY DISTRICT
ATTHIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NEC'T'ION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID *.....................................TIGARD SANITARY lDISTRICT
By
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CCNNEMION INSPECTED AND APPROVED
�� Date — Superintendent
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Address//� J-004V wif Permit No. _
Name of Occupant Permit charge
Connection fee
-- Paid by__ _
Date connected er
Type of Building - ------__-_— Inspection
Service Hats _ —_ Paid by
Contractor Assessment Paid—_
Size of connection___ _