1992, 05-29 Permit App: 92003833 Sewer JOB ADDRESS: 6 4401e*- 9 ,4 11Q
SUBDIVISION: LOT: BLOCK:
OWNER: 'RA ry by . l & 2 c/ h e l ry PHONE: 569 92- 637 c
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ADDRESS: C ( 3�f 2O `1 - 44 .
CONTRACTOR: PHONE:
ADDRESS:
LICENSE #:
INSPECTION DATE:
TYPE OF OCCUPANCY: (I) Sit-1/f rn l
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