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12110 9W HALL BOULEVAE+D
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT V 666 DAT$
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM 1F TIG-ARD SANITARY DISTRICT
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THIS Pt%MIT IWUST BE POSTED dN THE DESCRIBED PREMISES UNTIL CON-
NECTION 1S WADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
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PERMIT FEE PAID I_. " _.........................TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED ANi► APPROVED
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Address 'e°Z n ,�� /'� Permit No.
Name of Occupant �rJ-Y. IJC. L�. � zQ,�� Permit charge_
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Paid
- - -- — - .-. Date connec,nd— '/Z ,
Type of Building__ — Inspection fee _
Service hate raid by ___ --Date--
Contractor.- AssessmentL� Paid_
Size of connection 34
Address.. 2"�_ !O 4CAry Permit No.J,
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Name of Occupant -J—J. A S4t=tA4J-n2 Permit charge,
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Paid by�j,�W_ cot"
-- --- -._.�_-�_---- Date connected. 7 — G�
Type of Building Inspection fee—_
Service Bate— 8'' �_ Paid by S1;L. " Date/0
Contracto Assessment 1 Paid
Size of connection
W �3D