11780 SW 91ST AVENUE 11780 Sk 91ST AVENUE
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Permit No.
Name of Occupant Permit charge
`00 Ineelies -- i
Paid by -- -------— ——
Date connected
Type of Building Inspection fee_
Service Bate_- (� Paid by — Date _
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Contractor _ - Assessment_�p i O 0 Paid
Size of cor.nAetion