11590 11592 SW LOMITA AVENUE 11590 & 1,1592 SW 60MITA AVENT."
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Name of Occupant_YoS!`'l NUS'f__v Permit charge
Connection fee
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Date connected /y//o,03
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Ty,-,- of quilding w�LF _ Inspection fee
service Rate__Da Paid by �•C'./(�La'c�� Date o�o�
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Size of connection�__
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT N9 746 DATA(rU�
PER311T IS GIVEN TO
TO CONNECT A 'J� ' AY11
TO THE SYSTEM OF TIGAR,I SANITARY DISTRICT
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TH IA PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
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PERM[T FEE PA)Cl1 ...............................TIGARB / PIT:IRY DISTRICT
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CONNECTION INSPECTED AND APPROVED
Date Superintendent
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