11855 SW WARNER AVENUE 118'.:5 SW WARNER AVENUE'
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Address 5 l �/ Parmit No.
Name of Occupant / -k1 N a�' � Permit charge
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Connection fee — -
Pada by
Date connected
Type of Building_Jif->� -► 'Yam Inspection fee-- —---
Service Rate __ Paid by
ContractorTti:;��_=— ttr,'f�' Assessment-- Paid _
Size of connection -�
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