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11675 SW 90TH AVENUE r _ 9 y�y v r �W-1 * AVENUE 11675 SW 9OTh 1 of • i d� Address 4�� 9�/ _Q Permit No._ Name of Occupant_ / Permit/charce _ 1 cemweteir�eUU Paid by Date connected Type of Building Inspection fee Service Rate--2 1 Paid by __Date Contractor _ Assessment_[&1 D Size of connection iwl� C-Y �/