13810 SW 100TH AVENUE-1 13810 SW 100TH AVFNUS _
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ACORESS r~ S ! ��o _ PERMIT NO.
PERMIT CHARGE none
0l.;`;ER Z_f �-- _ CONNECTION FEE
! PAID BY
TYPE OF BUILDING 4 DATE CONNECTED
SERVICE RATE �_�� INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTIuN A55ESSMENT PAID