10375 SW MEADOW STREET 10375 SW MEADOW STREET
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PERMIT TO CONNECT
Tigard Sanitary District s---2
PERMIT N? ( DATE
Y {�
PERMIT IS GIVEN TO -----
OF
TO CONNECT A��_TO THE TILE SYSTEM OF TIGARD SANITARY DISTRICT
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THIS PERMIT MUST BE POSTED ON THE DESCRIBED(`REMISES UNTIL CON-
NE-,TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE SAID .:.....................
..TIGJL%D SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
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.4ddrese „T1� 11�� Permit No,
Name of Occupant Permit charge_
Connection fee
Paid --
Date connected
Type of Building — - -.._____-- Inspection fee_
Service Ra'a Paid by
C::"4actor _ Assessment- - Paid _ _---
Size of connection