9785 SW MCKENZIE PLACE f
ow TV A w NW&W-Am-Am
9785 SW MCKENZIE STREET
1
4J
11
'?I
I
Address J_1_' ����i L _ Permit No._ J
Name of Occupant �� _2 Permit charge
`6
l
Connection
Paid by
— -,_ Date conne--d ---Lc�__;2,
Type of Building__ i,, Inspection fee
Service Rate J e 6 0 Paid by _ ____Date
10
Contractor. L -yL-�
y Paid
Assessment
Size of connection_