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M EH FILE RECORD INI"ORMATIOe^911M <br /> Siq,c,PS <br /> Action County P r o g/Sub E l e m CVr4xAw No. <br /> E . N . (assigned by clerk) <br /> P/S . E . Local Comp . Number Su Dist . location Code Fee Ex'. <br /> 10 jyj <br /> Previous Camp, Numac-n Effective Dace Other Program Activity <br /> LU <br /> SITE NAME (00 ctwraclorr) <br /> � a1g s � <br /> SITE Address (no;/Vi r/Street/Suffi.x/Sui te) Site City/State/Zi <br /> DV <br /> PREVJOUS DDA <br /> Uillir ilt�m� - . <br /> Billing ,Address (No/Dir/Street/Suffix/Suite) Billing' City/Stat_e/ZiP <br /> CO 13b <br /> EST t�'2E ;a TE TELr-f`re *f-"40EFf <br /> I .Meats ..r.� <br /> Sq. fit. <br /> IUnits <br /> OWNER W-ME (Op chw.ac4ot3 j . <br /> 0,VNER Address (No ./Dir/Street/Suffiix/Suite) Nner City/State/Zi p <br /> SPECIAL PROGRAM INFOR,41ATION No. o4 Sarvlci Source o6 Treatment Population <br /> Connections SuRFIY Type Served <br /> LE-:1ealth dater <br /> ADDITIONAL COM IIENTS : j�,ti xk <br /> San. Sup, A Cr <br /> ER <br /> 01 15 <br /> F <br /> .�. <br />