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L ' •••••••■■•• „ - - <br /> % . <br /> ft.9 cc r.4! <br /> • <br /> •!- ' 44.14 <br /> - 4 ," ; <br /> ,t1',114 (.1'71 <br /> - ' /18 ****** <br /> . 1“.• I • '1 V L.111 rtni.. v■-avv11 I 1111%.2 urrit,c ur rHOLol) tauur T <br /> Acknowledgement below does not Imply acceptance of concurrence, but simply receipt of a cop Y of thls form, placing <br /> the building permit owner on notice of this assessment and the conditions of payment for same. <br /> • DATE • <br /> RECEIVED BY <br /> RECEIPT NO. j/7,/,.1,W DATE ,Z2 etZ2. BY <br /> • <br /> • <br /> • . <br />