12475 SW 127TH AVENUE-1 L-i u L-1 L-i L-i u u i 1 1
12475 SW 127TH AVENUE
r
r1u'
Addresew�L2�a75 s.w. lth Per_mi L No. 1594 - �..--
Permit charge_
Owner Dale Construction Connection fee_ 40o no —
Paid by Dale Construction
MW
Type of building Residence bate connected ,l} 1_,L
Service .rate 3•00 •- month — Inspection fee__ G�
Contractor_
Paid Die_u,-,,—,A __ Dat e
Size of connection 4" Aseessment_ Paid
f
PERMIT' TO CONNE�'T xis'
Tigard Sanitary District •-
PERMIT N9 1594
DAT>C ,
PERMIT I5 GIVEN TO
or
TO CONNECT A
TR THE fiYSTEM OF TIGARD SANITART DISTRICT
THIS PERMIT 51..,T BE POSTED ON THE DESCRIBED PREMISES ITUTIL CON-
NEC`TION IS MADE AND INSPECTION OF CONNECTION IIAS BEEN COM-
PIXTED.
PERMIT FEE PAID $_ . .- ,.,,.�;a,,,,„„••.TIGARD SANITARY DISTRICT
fly
1
CONNECTION INSPECTED AND APPROVED
i
PERMIT TO CONNECT , �4*_
Tigard Sanitary District
PERMIT Nn 12 9�' DATE
PERMIT 1S GIVEN TO
OF,
TO CONNECT A_ +�
TO THE STSTEM OF TIGARD SANITART DISTRICT
AT 2
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNEC71ON HAS BEEN COM-
PLETED.
PERMIT FEE PAID ;. ,.......,,�..TIGARD SANITART DISTRICT
By -»-
CONNECTION INSPECTED AND APPROVED
--- - -- Date