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56904***RECEIPT*** Date: 05/17/13 Receipt: 56904 Quantity Transactions Reference Subtotal 1 Building Dept Fees -Building Permit 13-4480 $250.00 Total Paid: $250.00 Notes Payment Type CK#1124 Amount Paid By $250.00 PBJ Holdings LLC Peter B Justo Name: PBJ Holdings LLC Peter B Justo 161 Lake Shore Drive Lake Hiawatha, NJ 07034 Clerk ID: JF Internal ID: 13-4480