11890 SW GREENBURG ROAD 11890 'W GREENBURG ROAD
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Address//YID ` /y- L,i Permit No. g
Name of Occupant - ( Permit charge _---
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- --- -- Paid
Date connected - /,4
Type of Building SLC tlz.'44 Inspection fee,.-_
Seri ice Rated•' Paid by r -Date___-__,__-__
Contractor -_ Assessment�_�o tr,_7t? Paid
Size of connection _