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11685 SW HALL BLVD I �r i (q cr I' d j 1 1 i 11685 SW HALL BOULL.JARD � I ffi Addrea ` —�/' Permit No. '� O Name of Occupant d ,k O CJIzL ' Permit charge Paid by_ Date connected^ % Type of Bufican4--IlCi.2.L.; -,r�` -_ Inspection fee-- Service Rate :2 c —_ Paid by _ __-- Date Contractor RRAessment Paid �i Sine of connection 1 _.