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11865 SW 95TH AVENUE-1 11865 SW 95TH AVENUE ,I I v r. v a; u Ln rn 3 U*i w 00 1 J " Address ZZ �_��_�- Permit No. Nam, of Oce.. •ant Permit charge Al 1 — -- — — _—_ Paid by -- - Date conne;ted ,3 Type of Building _ l nspec"0 fee /O, C G _� Service Rate rM C _ Paid by Date Contractor e► v ('d AssessmentJ?k— OPaid Size of connoction_bL[�_ _-