HomeMy WebLinkAboutPayment FormHEALTH
PAYING ON:
RECEIVED FROM:
PAYMENT FORM:
St. Lucie County Health Department
5150 NW Milner Dr Port Saint Lucie, FL 34983
#: 56-SF-2374985 BILL ooc #:56-BID-5610093 CONSTRUCTION APPLICATION #: AP1733833
ASHTON SEPTIC TANKS, INC. AMOUNT PAID: $ 545.00
CREDIT CARD 002365 PAYMENT DATE: 09/30/2021
MAIL TO: Hopeton Smith
FACILITY NAME:
PROPERTY LOCATION:
4800 Indrio Rd
Fort Pierce, FL 34951
Lot:
Property ID:
1418-133-0030-000-4
EXPLANATION or DESCRIPTION:
Block:
QUANTITY FEE
128 - OSTDS Construction System Inspection Research Fee
1
$
5.00
-1 - Surcharge (All)
1
$
45.00
-1 - OSTDS New Permit Surcharge
1
$
100.00
-1 - OSTDS Construction Application and Plan Review,New
1
$
100.00
123 - OSTDS Construction Site Evaluation
1
$
115.00
126 - OSTDS Construction Permit (New or Mod, Amendment)
1
$
55.00
127 - OSTDS Construction System Inspection
1
$
75.00
133.- OSTDS Construction Reinspection
1
$
50.00 .
RECEIVED BY: EvansJS AUDIT CONTROL NO. 56-PID-5271170