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PAYMENT SLIP
Code Compliance Division 2300 Virginia Avenue Ft. Pierce, FL 34982 )hone: (772) 462-1553 Fax: (772) 462-1168 THIS IS NOT A RECEIPT Permit Number: SLC- 0502-1081 Contacts: Property Owner Contractor Payment Slip c.0"60AV/ Building Residential (SIR) Permit Date: 05 Anril 2005 Reserve Homes Ltd Lp VAH, ROBERT JOSEPH (772)394-5600 (561) 781-1704 II . Job Address: 9008 PUMPKIN RIDGE Rdg Total Unpaid Fees $ 5,516.76 Fee Description: Amount Due: Build163 Building Information Management System $2.00 FireE141 Fire/EMS Impact Fee $294.00 Inspe234 Inspector Trust Fund $14.38 LawEn277 Law Enforcement Impact Fee $172.00 Libra190 Library Impact Fee - District A $182.00 i ParkI108 Park Impact Fee - District A $456.00 Permi602 Permit Fee - Single Family Residential/Commercial $913.00 Publi118 Public Building Impact - Correctional $231.33 Publi605 Public Building Impact - General. $115.67 Radon206 Radon Fee $14.38 RoadI209 Road Impact Credit - 3 ($2,059.00) RoadI430 Road Impact Fee - District 3 $2,059.00 Schoo104 School Impact - Single Family $3,122.00 Total Unpaid Fees: _ $ 5,516.76 N eeG\ 1\1 OL IV© L� C I V M 5 110'5�