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1/20/2012 (4) RECEIPT REPORT Date: 01/20/12 Time: 4:10pm Village of Tequesta Page: 1 ------------------------------------------------------------------------------------------------------------------------------------------------------------- Account Number Customer Name Cycle Receipt No WATER MONTHLY SE METER TEST RESERVE CA FIRE PROTE Location ID Section Entry Date RECONNECT REFUSE/REC FIRE LINE UTILITY TA RETURNED C Total Paid Service Address Posting Date SEASONAL PENALTY DEPOSIT RE METER CHEC Other Balance Due ------------------------------------------------------------------------------------------------------------------------------------------------------------- 2141370132 JOHN S ATCHLEY CYCLE 1 1 0.00 13.77 0.00 0.00 1.06 CYPN-000435-000B-03 14 01/20/2012 0.00 0.00 0.00 1.34 0.00 16.17 435 N CYPRESS DR #B 01/20/2012 0.00 0.00 0.00 0.00 0.00 0.00 2150830146 CAREY DIX CYCLE 1 2 178.10 15.73 0.00 0.00 0.00 RSDN-019669-0000-04 15 01/20/2012 0.00 0.00 0.00 0.00 0.00 200.00 19669 N RIVERSIDE DR 01/20/2012 0.00 3.57 0.00 0.00 2.60 630.01 ------------------------------------------------------------------------------------------------------------------------------------------------------------- Total Payments: 2 Grand Total: 178.10 29.50 0.00 0.00 1.06 0.00 0.00 0.00 1.34 0.00 216.17 0.00 3.57 0.00 0.00 2.60 630.01