13705 SW 110TH AVENUE! LJ LJ LJ,LJ L-0 4J LJ Li ,kLi 1 1 \I-
13705 SW 110TH
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ADDRESS ��� ,'� 1� PERMIT NO. -745-0
PERMIT CHARGE none _ _
0�� E R _ a CONNECTION FEE _�C�C) • ______,�
P A 10 8 Y da
TYPE OF BUILDING DATE CONNECTED
SEP,VICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION A55ESSMENT PAID