12600 SW PACIFIC HIGHWAY 12600 SW PACIFIC HIGHWAY
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Address Po;mit No.
Name of Occupant Permit charge
4
Geefeeligm fee lJ
paid
Date connected
Type of BuildingkI��eInepectivn fee _
Service Rate___._ Paid by Date 8
_ 1
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Contractor--- -- _-._--� _ Assessment___. ------_ - _Paid_ _
Size of connection