178 Beach Avenue TREE 15-DRTV-1011 Payment City of Atlantic Beach
Offsite Payment Form
Date prepared: 03/09/15
Deposit Date: 03/09/15
Prepared by: E. Hall
Payment Cash GL Account or
Type Receipt Accounts Receivable Deposit
Code Number Description Number Amount
TR Permit#15-DRTV-1011 112-0000-366.00-00 735.00
Total Deposit 735.00
Cash
AC H
Checks 735.00
Money Orders
Total 735.00
Revised: 04/29/09
O:\Finance\finance forms\Offsite Payments\[Offsite Payment Form-Tree Fund.xls]Tree Fund
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Cantrell Construction, Inc. 5271
1015 Atlantic Blvd 63-751/631
5 Atlantic g
Atlantic Beach, FL 32233 �! �y Date/
Day to n G% /T/ e a(.Y $ 73.S" `�
8 1 the order of �/
s Dollars t x k'
Wells Fargo Bank,N.A.
° Florida
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Wellsfargo.com nom. l �,p�
for 1 ` IS 6A-c•l'1 l fri.C. 104-
1:063L075L31: 5LS566904611° S27L
•
City of Atlantic Beach
REPRINT
*** CUSTOMER RECEIPT ***
• Oper: ATLBBJA Type: OC Drawer: 1
Date: 3/09/15 00 Receipt no: 36758
Description Quantity Amount
TR TREE MITIGATION DONATIONS
1.00 $735.00
PERMIT#15DRTV-1011
Tender detail
CK CHECK 5271 $735.00
Total tendered $735.00
Total payment $735.00
•
Trans date: 3/09/15 Time: 10:20:20
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