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58107*** RECEIPT*** Date: 06/28/13 Receipt: 57807 Quantity Transactions Reference Subtotal 1 Sign Permit 13-4788 $150.00 Total Paid: $150.00 Notes Payment Type Amount Paid By CK #9643 $150.00 Lite Brite Signs Name: Lite Brite Signs 51 Montgomery Street Middletown, NY 10940 Clerk ID: JF Internal ID: 13-4788