11505 SW MANZANITA STREET 11505 SW MANZANITA STREET
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Addreee.6if'W� t.n, � Permit No.
Name of Occupant Permit charge
Connection fee__— +�
-- _ Paid
Date connected
Type of Building Inspection fee-
_-- p _-_ -- --------
Service Ante_ --- J.'aid by _ -_ Date
Contractor Assessment Paid
Size of connectio,.
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PERMIT TO CONNECT
Tigard Sanitary District
PERMI'r N? t O 5 7 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT _
THIS PERMIT MUST BE POSTED ON THE DFRCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION IAS BEEN COM-
PLETED,
PERMIT FEE PAID $.... ..-._..... ..........TIGARD SANITARY DISTRICT
9993 By
-------------
CONNECTION INSPECTED AND APPROVED
Date, Superintendent