12125 SW 92ND AVENUE-1 IVA
12125 SW 92ND AVENUE
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Address __ �j��-e_ Permit No. °�• o G� �',�
Name of Occupant Permit charge
Y?" ��- � 0�ys�� _ Connection fee 7 10 , C d _
-- Paid by_—- ►Q, C
Date connected
Type of Building
Inspection fee
Service Rate —?(La _- Paid by _ - - _ Date
Contractor .� � Zs � �-y{ Assessment_ _ Paid__
Size of connection._ 4Z/jy,