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PUBLIC WORKS DEPARTMENT STORM DRAIN CONNECTION PERMIT No _ DATE: PROPERTY OWNER Name Address LOCATION OF CONSTRUCTION PAID BY Name Address APPLICANT SIGNATURE CASH CHECK No. Permit Fee $53.00 Received FOR STORM DRAIN CONNECTION PERMIT at above Location. LEWISTON PUBLIC WORKS DEPARTMENT BY Lewiston City Ordinance 74-43, 74-44, 74-54 & 74-87 SIGN