12695 SW 121ST AVENUE 12695 sw 121ST AVENUE
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i �``..� _ PERMIT
NO.
ADDRESS �-?��--�
PERMIT CHARGE none
CONNECTION FEE �OD
OWNER «' .;,,,
PAID BY �"��� '"'
DATE CONNECTED '
TYPE OF BUILDING
� INSPECTION FEE
SERVICE RATE --~---- DATE
PAID BY
CONTRACTOR ASSESSMENT PAID _
SIZE OF CONNECTION