11545 11547 SW LOMITA AVENUE 11545 & 11547 SW LOMITA AVENUE
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Address /�' .1" < > !U. .Go i /J Permit No.^�
Name of Occupant i Fit^i4/Il i^�f�Q� Permit charge_ -r7 e,
Connection fee_
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Date connected
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Type of Building yrs ".Olex _ Inspection fee__
Service Rate. Paid by (r4-t laeC&-' Date
Contractor (-nf- /111,c.0 L ���1 Assessment---.- Paid—
Size of connection
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PERMIT TO CONNECT
Tigard San..Aary District
PERMIT N(.) 13$ DATE,
PERMIT IS GIVEN TO � �'•' '`!'� '—.___�m ___
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTIG:" IS :'MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $...!4r ..f.�� �
...................TIGARU SANITARY DISTRICT
BY ' .4 �__�_
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CONNECTION INSPECTED AND APPROVED
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Date Superintendent