Laserfiche WebLink
' FILE RECORD INFORMATIONINM <br /> S <br /> Kf� c�W r o g/Sub E 1 e m caro""No. <br /> k,H (assigned by clerk) <br /> cal Number Su ZDist . location CodeFec Ex. <br /> D r STA 0 3ZI rT/ I Q <br /> revious Comp. uMoEn Effective oats Other Program Activity <br /> of z -7 <br /> SITE NAME (00 ctwaclo(e) <br /> 14SGaz l�FiL-rr4- <br /> SITE Address (no./pir/Street/Suffix/Suite) Site City/State/Zi <br /> 8/3 -7394"7 <br /> PREVIOUS DOA <br /> Billing flame _ <br /> a5 <br /> Billing ,Address (No/Dir/Street/Suffix/Suite) Billing* City/State/Zip <br /> SAIW-k- (As 40(17s <br /> y� Tones — 11 /�lgg0� �r 0? / EST SJZE SITE TEL htOrE"'IDER <br /> I Seats „<. <br /> i,e, sq. Ft. 4.LJ J <br /> 1' Units <br /> OWNER NAME (00 uwacw3) . <br /> a <br /> OWNERAddress (No./Dir/Ctreet/Suffix/Suite) O.rner City/State/Zip <br /> SPECIAL PROGRAM INFOR!IATION No.of S•rvici - ource of Tratment Population <br /> Con Type �ry <br /> Rdc. health � Wa r ! <br /> ADDITIONAL COIIMEN �tG7l�I/ c S{�h4 e <br /> San. Sup. A , sqr , <br /> a <br /> ESI 01 15 �pfj 9 \ l <br /> III I LN-j <br />