11515 11517 SW LOMITA AVENUE 11515 & 11517 SW LOMITA AVENUE
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Address_-- /�n �. IN �o�/T� ��P • Permit No,
Name of Occupant__ ��/ �t cc e i/l Permit charge 'l
Connection fee ec,
Paid
----- _.---- - __ — Date connected &1"lo
Type of BuildingInspection fee
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Service Rate W�/f Paid by (!4• •-1�6)Data
Contractor (.E k lc c 5 e'�-' Assessment- Paid
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Size of connection -el
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT No 737 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A ------
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTII.CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
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PERMIT FEE PAID $.. . ............................TIGARD SANITARY DISTRICT
Byt -
CONNECTION INSPECTED AND APPROVED
DAte Superintendent