11720 SW SUMMER CREST DRIVE 1.1720 SW SUMMER CREST DRIVE
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PERMIT TO CONNECT
.Tigard Sani�ary Distract
PERMIT 1�1�' 1372 DATE // .•2
PI?RMIT IS GIVEN TO �,�._• � �`��� � "�• r
OF
TC CO?414ECT A
TO THE SYJTEM OF TIGARD SANITARY DISTRICT A �* r
k?Alr
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_ ---�---
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES I XTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS I'R&I COM-
PLETED.
PERMIT FEB PAID #•••• «••�•`+� TIGARD SANITARY DISTRICT
I f1NNP.CTION IN;PFUTED AND APPROVED
i
-Bate`� � � Superintendetat w
illuT I.F-W
Address 11.7 Formit No .
Permit charge __
Connection fee ';'5
Owner _._
Paid by
Type of rl,lilding_ - -- Date connected
Inspection fee
Service rate p ----�� ---•-
Contractor Paid byDate
Size of connection Cfiw _ _ Assessment _ —Paid
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