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58667***RECEIPT*** Date: 08/26/13 Receipt: 58667 Quantity Transactions Reference Subtotal 1 Building Dept Fees -Building Permit 13-5122 $175.00 Total Paid: $175.00 Notes: Payment Type CK #923518 Amount Paid By $175.00 Fidelity National Title Insurance Compan Name: Fidelity National Title Insurance Company 898 Veterans Memorial Highway, Suite 340 Happauge, NY 11778 Clerk ID: JF Internal ID: 13-5122