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11715 SW 95TH AVENUE 11715 SW 95TH AVENUE 4 • i Address��,�1�--` � Permit No. — ----`, �-- Name of OccupantPcrmit charge!_____ Paid by -- ----- --- ---- ----- - Date connected S' Type of Building- ____ Inspection fee Service Rate_ _.._ Paid by _..__._ Date —.------ Contractor . _. Assessment—�141�Paid_^ Size of connection