12520 SW 124TH AVENUE u tJ
12520 SW 124TH AVENUE
1 .1.
I
1 LL•
T
w• ,
U
i
1
� J
�mffll MUSCUM-A WJ�Rm
WIN
PERMIT T TO CONNECT R-0
Tigaid Sanitary District
1
PERM r N? 1473
DATE
h '
PERMIT 1S GIVEN TO
OF
r j
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUi;T BE POSTED ON THE DE4CRIBrD pR.R1✓ISF.S UN1'1t CC);,%,_ '
NECTION IS MADE, A:vD INSPECTION OF CONNL,0TION HAS BEEN COM.,
PLETED, 7 r
PERMIT FEE PAID $....�..f.�!,,.,p.,.......'r1(;ARD SA ilTARY DISTRICT
1 By .:.'
��IIIM�
CONNECTION INSPEC'T'ED AND APPROI'F:)
_0_'
i
I
�I
ti� • ��
Address /.a6�2 `/w I'ay , Permit No .-
Permit
ooPermit charge
owner �' � ����% -may-. %7��1'C Connection fee
Paid by
Type of building moo. w Date connected
Service .r-.te Inspection fee
Contractor Paid by Date ._..._.__._
` Assessment Paid
Size of connection {H __. _---_
S7 E,�-
4 � I