13015 SW GRANT AVENUE V.
GRANT
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Tax Lot 2 SI Z BC 4300 23-1.0 NorthTi.gardvill,-i Addn
Assessment 525.19
Lateral
11-1-61 26. 16
S SA thereafter.
76 Address ���`� V/��1 j1,1 _ Permit No.-_—_-_
NamF of Occupant__ — Prnnit charge. -_.,_--_ ._
Connection fee
- -------- --- --- - - ---.- Paid by__Date connected
1'ype of Building _ Inspection fee
Service Rate — -_ Pf_id by _----Date
Contractor------.- -_______..-_ Assessment ��4 1�_Patd
Size of connection