11590 SW GREENBURG ROAD 11590 SW GREENBURU ROOD
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Address j1;� �11 �d.l!/, XJ- ., Permit
Name of Occupantl_L � tC Permit charge
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Paid by—_
— Date- connected /,0 J
Type of Building �� _ Inspection fee
Service Rate__ �L, D O — Paid by , - Date -- ---
Contractor Assessment74P t�J�O paid`_
Size of connection—J-1-
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