11970 SW LYNN STREET 11970 SW LYNN STREET
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PERMIT TO CONNECT
Tigard Sanitary; District
PERMIT 1 N 15 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIPARD SANITARY DISIMICT
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AT ".
TKI3 PER NIT MUST BE POSTED ON THE PRESCRIBED PR.:MISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
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PERMn' FEE P ID $....................................TIGARD SANITARY DISTRICT
BY --
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CONNECTIDN INSPECTED AND APPROVED
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~Superint�endent ___.
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Address –r•11.-'..'ll j -' Yc' t .. � Permit No.__/
Permit charge
Owner Connection Lee`
Paid by
Type of ts;..i.lding ,q ' _ Date connected
Service Rate- Inspection
Contractor`s Paid by Date
Size of connection!_ / "_�,���� � �`_ Assessment _— P:iid����