12355 SW MAIN STREET 12355 SW MAIN STREET
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Date connected
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Type of Building— ji.c- .0 _ Inspection fee____ _
Service Rate_ -�� �� _ Paid by Date_
Contractor— _ _ Assessment Paid
Size of connection
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Name of Occ pant:.u�,r�ft�' q o Permit charge
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Type of Building. V`"f- ,^^
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Service Rate 7y d l) Paid by
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Contractor Assessmenty_
Size of connection 'jLA