950 MAIN ST - CASH RECEIPT L,ii?`�" t '
Cash Register Receipt Receipt Number
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~ City of Atlantic Beach R3310
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DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK i. $7,512.83
RES17-0185 Address:.950 MAIN ST APN: 170961 0000 " , $7,512.83
BUILDING 11 $762.00
BUILDING PERMIT 455-0000-322-1000 I' 0 $762.00
' BUILDING PLAN REV RESUBMITTALS I ' $50.00
BUILDING PLAN REVIEW RESUBMITTAL 45500003221006 0 $50.00
SECOND
" BUILDING PLAN REVIEW 14 1. $381.00
BUILDING PLAN CHECK X455-0000-322-1001 0 $381.00
PUBLIC UTILITIES . $6,090.00
CROSS CONNECTION 400-0000-343-3701 0 $50.00
CROSS CONNECTION REINSPECTION 400-0000-343-3701 0 $50.00
WATER METER AND TAP 400-0000-343-3302 0 $800.00
SEWER SYSTEM DEVELOPMENT CHARGE 415-0000-324-0301 1 $4,050.00
WATER SYSTEM DEVELOPMENT IMPACT
415-0000-324-0301 1 $1,140.00
CHARGE
PUBLIC UTILITIES PLAN`REVIEW $50.00
PU REVIEW RESIDENTIAL BLDG 001-0000-329-1007 0 $50.00
PUBLIC WORKS PLAN REVIEW ' I $100.00
PW REVIEW RESIDENTIAL BLDG 001-0000-329-1004 0 $100.00
STATE SURCHARGES I- $29.83
STATE DCA SURCHARGE 45500002080700 0 $11.93
STATE DBPR SURCHARGE 455-0000-208-0600 0 $17.90
ZONING PLAN REVIEW"=''. �,.I . - $50.00.
ZONING REVIEW SINGLE AND TWO FAMILY
001-0000-329-1003 0 $50.00
USES
TOTAL FEES PAID BY RECEIPT: R3310 $7,512.83
Date Paid: Monday, October 30, 2017
Paid By: BUILDING UNLIMITED ROOFING &S
Cashier: LE
Pay Method: CHECK 1052
Printed: Monday,October 30,2017 12:13 PM 1 of 1 ir
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