Refund on Sewer Charges 2012 CHECK REQUEST
DATE 01/11/12 6 r
VENDOR NO.
PAYEE Beaches Habitat
LJlilr)''
ADDRESS 1671 Francis Street
CITY Atlantic Beach
STATE Florida
ZIP CODE 32233
ACCOUNT DESCRIPTION ACCOUNT NUMBER PROJECT NO. AMOUNT
800 Stocks Street
System Dev Charge Sewer 4100003435200 Permit #11 -3020 $4,050.00
800 Stocks Street
Water Meter Charge 40000003433302 Permit #11 -3020 185.00
800 Stocks Street
Cross Connection Fee 40000003433302 Permit #11 -3020 50.00
Subtotal from Page 2
TOTAL $4,285.00
DESCRIPTION OF ITEM OR SERVICE:
Refund Beaches Habitat overcharged for sewer sdc and water meter. SDC had already been paid and existing
water meter on site. (dwelling was demolished from this location)
SPECIAL INSTRUCTIONS:
See attached email. Any questions please contact Donna Kaluzniak.
To expedite processing, please attach adequate documentation to support payment.
ADDITIONAL APPROVALS ONLY REQUIRED
WHEN CHECK REQUEST IS OVER $500
dwhite for donna k 1 -11 -12
/4/46/14- ' ""1- REQUESTED BY / DATE P T HEAD / DATE FINANCE DIR / DATE CITY MGR / DATE
Effective: 5/10/04
Revised: 5/19/04