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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N . 3 8 3 LATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF ) GARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UsML CON-.
NECTION IS MADE Gr.0 INSPECTION OF CONNECTION H&S BERN COM-
PLETED.
PERMIT FEE PAID E......: ., :1......e-U...........71CARD SANITARY DISTRICT
By
IrA ,h 4�M
CONNECTION INSPECTED AND APPROVED
Date Superintendent
I
Q- Permit No. L3
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Permit charge
nwrer -mssu��� C�ss ��, Connection fee
s /�G%y.� ✓ _ ,:c _ Paid by _ _._...__._..._�_..
Type of building Date connectea
Service rate Inspection fee__,
Contractor Paid by_ Date
Size of connection {�� AssessmentPaid�