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Address 12725 S.W. 128th Ave.
_ Permit No. 4711
Permit charge
Cerner DFale Construction Connection fee 425
Paid by Dale Construction
Type of building Re- ',,deuce Date eonrected w 10-27-72
Service rete 3.00 per_month Inspection fee
Contractor Delp Construction Paid by same DFkt ,
Size of connection 411 Assessment paid
174
� 300 �
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT 1304 DATE
PERMIT IS GIVEN TO
OF
f0 CONNECT A.____4
TO THE S7t13TEM OF TIGARD SANITARY DISTRICT'
AT r
THIS PERMIT MUST RE POSTED O' TIIE DESCRIBED PREMISES UNTII•CON-
NEC"FION IS MADE AND INSPECTIO 1 OF CONNECTION HAS BEEN COM-
Po-!:TED.
PERMIT FEE PAID ••,TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVE[)
Date Su, -rinten ent - - -- -