11820 SW SUMMER CREST DRIVE i
11820 SW SUMMER CREST :RIVE
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INSPECTION NOTICE
City of Tigard Building Dep-4rtment
12420 S.W. Main 'it.
Tigard,Oregon 9-1223
Phone: 639 41/1
Type of Inspection 6 12�-S'A?kf
Date Requested Time 01. P.M.
—reermit
Address
Owr'er #
Builder
The following Building Code defiriencies are required to be corrected:
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES eNO
Permit No. )_3(g :-
Address
Permit charge,,,_
00
Connection feeOwner-
Paid by -----
Type of building
Date connected
Inspection fee CV
Service rate -----
Contractor
Paid by_ Date_ I
t. Assessment_- Paid_______.
Size of connection k - �
i
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N�) 1362 DATE
PTRIIIIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCXIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID t.J;lq--= SANITARY DISTRICT
e7i BY
CONNECTION INSPECTED AND APPROVED
f
`-- --- Date Superintendent